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CA <br /> LAND USE PERMIT APPLICATION—Burnett County, WI [ <br /> 0 <br /> Applicant Complete All Sections Below This Line o' N 41. <br /> Permit Types and Fees(Please,check appropriate boxes) i; <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD <br /> .. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 c o <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 $Z <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 4 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c t) <br /> 111, <br /> Filling/Grading $150 Boathouse $500 <br /> rn <br /> Solar Panels Stand alone or roof mounted( ) $150 Permit Extension(1 Year Extension Allowed Once) $100 o <br /> ET <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. b `ik <br /> Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 1D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o —. <br /> Z <br /> Property Owner's Name: 1�j6 i At JCAIeesc iv• <br /> —.Ie <br /> 0 <br /> Ay n l <br /> Property Owner's Mailing Address: ©,8 c `rm! & e Ili sD P/fee i 1/v 'j 16? E' <br /> / ,-� City State Zip ° X --1 <br /> Property Site Address: 9.`t v75` �$T' ye//o G.'T i U er lzcd 'P4ILcer y L -i C <br /> o e <br /> Contact's Telephone Number: 7,S- 910-O'O6 a. <br /> d <br /> Contact's Email: Degeti-emrLIcAsiTc(CTi'L f/o7 ti(, eom <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0 °0 <br /> S' <br /> vo <br /> Legal Description of Property: o — <br /> � �/ w -v <br /> Section#: '7 Town#: i© N Range#: i G W Town of: OAK t412.O .. <br /> *Attach additional page if needed_for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> o F ,_, <br /> Tax ID#(1-5 digit number;found on tax statement): 13 9 P 'J <br /> � <br /> Proposed Use of Structure/Addition: De 4 t!1Etilp �4Q' w 3 <br /> Anticipated Start Date: '7•. L.ail. (Home/Cabin;Crunmercial Business;Bedroom;Deck;etc.) " - <br /> Building Contractor:DE 6 fi iiim 16 itsr 1---It-e Sewer Installer: rt- <br /> . <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY mo <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> o <br /> p /� l � �QV' � i <br /> O �l Q � W"_ a 3 m <br /> Fi <br /> cn <br /> NO ko 6e used `CUI Y UkV Y>aA t t 4tk+ Fee Rec: . <br /> z Check#: /C` <br /> o > <br /> r <br /> rn <br /> m <br /> n <br /> m <br /> rr p 1, < 1 _J <br /> cm co <br /> Date of staff site visit: ( )► 'J V 1 Initials of site visit staff: l,L-} KT > Q <br /> fin, b co. <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:,f Z{0/v(zy : 3 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o -- <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT I`` "' <br /> Page 1 of 5 L_� ' <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />