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' LAND USE PERMIT APPLICATION — Burnett County, WI b <br /> Applicant Complete All Sections Below This Line 0 -c- <br /> Permit Types and Fees(Please,check appropriate boxes) d <br /> P..' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD .,4 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> INk Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 o <br /> _)(' Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G•- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 cn r <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 tothree times the normal fee. ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> P <br /> Property Owner's Name: No r,h o c,1 4 3 C Loa I'fi Zi Yl o -� it <br /> Property Owner's Mailing Address:glad 1 St at--C., RnUL1 �) WI 54-0 ='. <br /> r� yy,�,� Q�,,,, ''\ City St`at Z' E <br /> Property Site Address:c t aa5 iV d 35 w (-t�- 5 mi l _ <br /> o Fo <br /> Contact's Telephone Number: 115 -SC.� -a55 3 d <br /> . � d <br /> Contact's Email: (,D h i i ttCU t (,,J 1 Id l r'less (A-ma i l ,c 01-1 \ <br /> **If staff has a question about this application,you will be con ed via email. Make sure your email address is b ) ' <br /> legible and your email provider will accept emails from the followin addresses: @BurnettCounty.org and V °Q �� <br /> @BurnettCountyWl.gov t f GSiu Vp r Zq f, Z 5' 1Legal Description of Property: p1 6 )a-� — r)ar^ 'Ala`c"r " 6. <br /> Section#: 3 a Town#: 9 b N Range#: i (p W Town of: 0 t�.k i an k r„ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* NJ' F <br /> � C7 <br /> Tax ID#(1-5 digit number;found on tax statement): -)--)--4E.--t-- 36 a 3 \ <br /> 2 Proposed Use of Structure/Addition: S •�arAq u-n��-S bld 7S y.� <br /> Anticipated Start Date: A t., I a o ,y d (Home/Cabin; ercial Busin ;Bedroom;Deck;etc.) <br /> Building Contractor: Pbt I ! e 17 w (d L.L L Sewer Installer: I� (� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ( -.0 <br /> THIS THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I. W <br /> C67/00 G// c,c,„, , DNS r',, cu P- z 3 -17... <br /> Z -7-7, r's pevoA,'7z- is ,r' o s7,-nj^Qpe /O u/'l/G(iNySf e-4cA <br /> b eA lA 06 / X /O 0 / C-cl Cil, I r g- U kI I' x Fee Rec <br /> 0/Wef- 6e- use Ice Aulmerm h410►'7�4 /d/1, <br /> c Check#: <br /> / <br /> v <br /> / ' <br /> Date of staff site visit: 6, 3��a V Initials of site visi f: f/i J l <br /> /)54/2-492.., o�'APPROVED BY LAND SERVICES OFFICIAL: ATE: y. <br /> 0 <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF 2 3 '_ +Unun� <br /> ~v o (-Az <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT __ N �, <br /> Page 1 of 5 <- '.`'- i <br /> ra i <br /> Burnett County, WI Land Use Application—Rev 3/2023 r l <br /> J <br />