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• -ne,r cpP oL ( 4,..i r Lip ro <br /> . ' LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0 CD I <br /> a. <br /> Permit Types and Fees(Please,check appropriate boxes) I � C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/R tainin Wall idewalkY Bunkhouse $250 ° , <br /> Driveways/&Campgroun res $125 J WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $i50 Boathouse $500 III <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 k lb <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> 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. J <br /> z r . <br /> Property Owner's Name: v 1 t 1 I al n v't e et✓- o <br /> I' f .� c YTS? d �, <br /> Property Owner's Mailing Address: j {/ Pee{ J 1 l �o L K��Cr n r <br /> City ' State Zip ° I <br /> Property Site Address:Xc", ' dS a60 Ve o r <br /> Contact's Telephone Number: 7I J —S, ql 7 `. <br /> /� J • o <br /> Contact's Email:j eQi1 1 a 1d JCo?p I'e't j (L`�' -N'1 I./Ci9A1 * `' <br /> **If staff has a question about this application,you will a contacted via email. Make sure your email address is N ro "1 <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov °o °Q N <br /> YL GL Y <br /> Legal Description of Property: ,J /- <br /> Section#: 2-7 Town#: .a 2 N Range#: /y W Town of: 7v Cie £ ice z' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7, cA <br /> 3 �' N N <br /> Tax ID#(1-5 digit number; found on tax statement): } _1g d <br /> Proposed Use of Structure/Addition: f rl Ia CIS e 4 ion: ice` a I"1/lI uGtf� .3 —) <br /> Anticipated Start Date: (Home/Cabin;Commercial usiness;Bedroom;Deck;et .) w <br /> x J - <br /> Building Contractor:-) t1 e' t atl eglo i�. Sewer Installer: N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> y <br /> €e, n'taG walls ore -4o be, reetaced in -4-kc.2 tXtu,4- ScW -e- m oc <br /> korAril---- 1 —(. <br /> , Fee Rec: <br /> (� -< __ _ <br /> ``J c An L I i d -Iv 6 3-QUA rtd t l a to - C C,146 9 `15/2 Check#: <br /> Pn <br /> v r— <br /> Date of staff site visit:7//OI Z024/ Initials of site visit staff: a a Y`, ME Cry co <br /> APPROVED BY LAND SERVICES OFFICIALE `t'-ld,l,(i DATE: 7/'ZIZQZy <.3 2 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT e, -A` <br /> V <br /> ITIV <br /> Pagelof5 LL JJ <br /> Burnett County,WI Land Use Application-Rev 04/2024 <br />