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LAND USE PERMIT APPLICATION — Burnett County, WI Cl) 0 <br /> b <br /> Applicant Complete All Sections Below This Line 0' ' 41. <br /> Permit Types and Fees:(P/ease,check appropriate boxes), n' <br /> C7 l <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 �, Q <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 _ .'O� <br /> i' Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 p\ <br /> FD <br /> Accessory Structure(Commercial/Industrial) $200 —Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 i\-... <br /> Filling/Grading $150 Boathouse $500 <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `5 ` <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. I <br /> z <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g' <br /> 11 i Property Owner's Name: fij YI^r4 r.p9 5 �G.t,, t` �,1 Ca'i.,‹P 1 <br /> Property Owner's Mailing Address: 7 /cc oG` V lkA)c,t-/t Pick,/ Lii e h S t r IA) <-9403 t r <br /> �L City State Zip ° $ <br /> Property Site Address: 7/��1� k W0.2� ►` Z < O <br /> o N til <br /> Contact's Telephone Number: (, c/,V , be/61C a <br /> Contact's Email: >~A -)c'c'S ( 4'4 �`e• t =% <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is v4 <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov V O p <br /> 5' <br /> ao <br /> Legal Description of Property: P n vr-c-.,r.l I<D-r S'o(1 d U V p ? <br /> Section#: .)- Town#: 35 N Range#: '6 W Town of: ,171't "‘c'' >^ 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* J dr Cl) <br /> o H <br /> Tax ID#(1-5 digit number; found on tax statement): Id ) $ c1. , <br /> Proposed Use of Structure/Addition: /UY Vic! Loili ‘70( �� Gt,IU 5 47/4 .i ? <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) J <br /> S ?1:0 i <=:, <br /> Building Contractor: Sewer Installer: N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z zp: <br /> o _ <br /> rn <br /> "MRO o. Sc bal,, .v, <br /> a m <br /> ° <br /> Fee Recap OW-- <br /> Check#: 4//O 3 <br /> z <br /> P <br /> m <br /> < l J <br /> (9/(0)7)� ( ODate of staff site visit: 1 Initials of site visit staff: ,L -3 2) <br /> Q <br /> APPROVED BY LAND SERVICES OFFICIAL: Aith-14) DATE: VOi/Z`f `�° so0 <br /> <.3 '< <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> oc <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 31:3``CD CD EN <br /> Page 1 of 5 �J <br /> Burnett County, WI Land Use Application—Rev 04/2024 - <br />