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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line c 0 <br /> Permit Types and Fees(P/ease,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v dSZYN <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ o <br /> ?( Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> CD <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 r <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 a. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> 6.... <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. ' 1 3 <br /> z <br /> .._ VI <br /> Property Owner's Name: •J)&At JA;t S o N <br /> b NJProperty Owner's Mailing Address: 2c5 70 7 SA, t'T}i Rvrtj ��5.�� �1i1` $'�R93 w n <br /> City State Zip N <br /> Property Site Address: 2 7G7 .Wl t '.n4 Rh lc/c r'� to► 5-1 s93 o N <br /> . <br /> co <br /> Contact's Telephone Number: SO3 �S 8 75'7 d <br /> Contact's Email: d c neS /43 1 C t4"'kV;I •C&r+1 c'' <br /> **If staff has a question lib61.1t this application,you will be contacted via email. Make sure your email address is N b <br /> o legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov ? °O <br /> Di C Sw ril eri51- /11i-LP OF 'rile n1ak1"14 er6r G2Jttrt re----R or Tilt'" c' <br /> Legal Description of Property: SGO i 7t 4.42e5 Ir. Cu J+4 e ER C S 97 A/E % SytJ%yl r.. <br /> E. <br /> Section#: "2.j Town#: 31 N Range#: / 7 W Town of: Li lt/Cc/4y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* (1) <br /> 1 _ lv <br /> Tax ID#(1-5 digit number;found on tax statement): I 019 N ...� �, 5 <br /> Proposed Use of Structure/Addition: 1..JccbSHEt) (Scree-z. S"l1tPPwk? Carr;W RR <br /> e ) -i r G <br /> Anticipated Start Date: c(6 f 2'-f (Home/Cabin; ommercial Business;Bedroom;Deck;etc.) ......1z W —0 <br /> Building Contractor: Sewer Installer: y r— L <br /> o <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY rn <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z x <br /> rn v <br /> �ef Spa < —' <br /> No+-f� cec� lac h�,�o;- . <br /> n <br /> cYl �z, <br /> .73 <br /> -1 Fee Rec: �. '� <br /> ° Check#: <br /> z <br /> r r Jl S <br /> Date of staff site visit:5122'202y Ini "ails of site visit staff'Stt 4-V(` W <br /> APPROVED BY LAND SERVICES OFFICIAL. JI f/1.4/ ,(�bebezzi CO <br /> �. <br /> ��� DATE: Is <br /> o r <br /> -C7 <br /> NO <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF _ N < <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> C <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />