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Cy r <br /> LAND USE PERMIT APPLICATION-Burnett unto, WI t i 4 <br /> 4. <br /> Applicant Complete All Sections Below This Line $' r <br /> Permit Types and Fees(Please,check appropriate boxes) e <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g Li <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `J <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration tciAccessory Structure $150 i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °. <br /> ip <br /> X Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' <br /> Filling/Grading $150 Boathouse $500 in.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 to three timesxhe normal fee. <br /> if 1 <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. .. z ' <br /> Property Owner's Name: Ross Swenson 1 Z <br /> r - <br /> Property Owner's Mailing Address: 28476 Blueberry Lane Danbury WI 54830 rn -C <br /> City , State • Zip 3 v.)Property Site Address: Same as above o W <br /> Contact's Telephone Number: <br /> 715-791-9441 E. <br /> G <br /> Contact's Email: bebespapa@outlook.com <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: @BurnettCountyWl.gov (;9° f <br /> CM <br /> Legal Description of Property: Princess Pine Shores. Lot <br /> d <br /> Section#: 13 Town#: 40 �N Range#: 17 W Town of: Union a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* '1' <br /> Tax ID#(1-5 digit number;found on tax statement): 25446 g 6 <br /> Proposed Use of Structure/Addition: patio/fire pit H G r.1 <br /> Anticipated Start Date: "61-141,24- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Self NA 1 d 3 <br /> Building Contractor: Sewer Installer: ts- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY rim z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i <br /> 0 1\46- al /4-ba. s CA <br /> NI _ <br /> 4 <br /> Fee Rec: _ <br /> 9 :Check#: 5`7%- <br /> .e <br /> / " lni of site visit staff: (,1* t1 • M <br /> Date of staff site visit: /�� l <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE:�/��/ZW Z 3 - 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Y <br /> 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3." <br /> m <br /> Page l of 5 <br /> Burnett County,WI Land Use Application-Rev 04/2024 <br />