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LAND USE PERMIT APPLICATION — Burnett County, WI - - <br /> Applicant Complete All Sections Below This Line ty <br /> r <br /> Permit Types anti Fees"Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i 77 W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,\� <br /> Accessory Structure(Garage,Shed,etc.) $150 ,Addition/Alteration to Accessory Structure $150 v <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 _ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 i - vv <br /> Driveways/&Campground StructuresStatute N <br /> pg $125 WI State '�9.6�2(iv)Structures 5350 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> �� <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. I -- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc, <br /> Property Owner's Name.: Mictio,ej .4' Ol' _ Neu. i C� <br /> 7 81 I .IASh 1 ti I I aka LGt kU4 lk�P raw 1 Property Owner's Mailing Address: r' <br /> City State 5,0141, - _..1 co <br /> Property Site Address: Z� t,,sQj (}^'x'ti <br /> Contact's Telephone Number: f(2 p t3O ' 1Q©f1® N <br /> J <br /> Contact's Email:__ M Welt berfe,ImAti .CO IYt <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: a R3urnettCountvW Wl.gov <br /> Lo4-Z C3PIA 1gbZ VoL2.4 Pt32A3DOE. 4VotZr n` '� <br /> Legal Description of Property: W <br /> Section 4: O? Town :: 41 N Range ',. (5 '.\ :. ,n ,, (511)/.55 N <br /> k touch additional page if needed,lol'leu,i'tln't esel-Mt/ori OR ati;,Il., i ,1 ,,,'..Ic a+. -t1()l,,lii::,ii! \h'1's c Ili/�iY1t+-'7l (htgt'." <br /> I d\ II)-(1 digit number:found on ta\ titatement):___ 3S l 0 --i <br /> Proposed Use of Structure'Addition: C'L!/17 - '1\1 <br /> Anticipated Start Date: t1U!E( $ r A <br /> Building Contractor: Sesser ln't.rller: kA F5hdiV <br /> AREA BELOW THIS LINE FOR LAND)SERVICES STAFF COMMENTS/CONDITIONS ONLY - <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> PIRA- cU St-Noas <br /> 0 Qwe-,ti Ylb- -1D aced 3 beci,rcomS fe-r SPN -2017 <br /> fnn� �,f (�L 1� -�a� <br /> V I n I D IUTT i4,4 rrs iit� Fee Rt4: l��z Check1 <br /> - r <br /> 1 - 1 J <br /> Date of staff site visit: 1Z41Ii.' uta;ft T Nu <br /> m �- <br /> Inr aso sitev 0 <br /> _ m � C� <br /> APPROVED BY LAND SERVICES OFFICIAL: _ -_D)ATE:�427 , _ 0 CD <br /> `•3 Innf <br /> co . ..a. UUU <br /> UPON APPROVAL: APPLICANT UST POST COPY OF o 0 0 <br /> r� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTco ' <br /> Page 1 of 5 .)J <br /> Burnett County, \\I Land l e Application —Rev 04/2024 <br />