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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> 14 <br /> Applicant Complete All Sections Below This Line 0 c41. <br /> Permit Types and FeesPlease,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 F r <br /> 00 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> X. Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 co <br /> R <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 0 II <br /> Filling/Grading $150 Boathouse $500 .» N <br /> 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 times the normal fee. `.q <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r. g' <br /> z <br /> Property Owner's Name: ;,,,4 v./y _Jae__ e„i(5-� o o <br /> /t <br /> Property Owner's Mailing Address: C.rz(P' l/1 t>o ,Q v,e___S COTT?'mi l j o/4 n <br /> �C+ _ City State Zip ° `" <br /> Property Site Address: 2 6 4P- f CAI/,✓LO l'�6� �a. o <br /> Contact's Telephone Number: / v -3 93 9 a <br /> d <br /> Contact's Email: .S16-0 4-/C 19 / �daL , Cis'. CD <br /> **If staff has a question about this application,you ill be contacted via email. Make sure your email address is N -0legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov S °Q <br /> l?/ c Q 5' <br /> Legal Description of Property: 2 t>`/,� Caa,,vo,—s Qr ''•`.0s.e, ' d <br /> (73 <br /> Section#: 0 Z Town#: -7 9 N Range#: J 6 W Town of: .4' f/49.t/ 5. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> 0 p <br /> QQ <br /> Tax ID#(1-5 digit number; found on tax statement): Q 2,� C" <br /> d <br /> Proposed Use of Structure/Addition: ,/'sue 1TP/W-S(-- .-3 f uJ <br /> Anticipated Start Date: ‘///1 Lf (Home/Cabin, Commercial Business;Bedroom;Deck;etc.) a <br /> /� x <br /> Building Contractor '%121 A. J Gd`Gic/< t'Tiy) Sewer Installer: ] ✓ /ctfL•,E4..fcA <br /> U1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> cn <br /> I \&c 4. \ \se 4r Her\ I *G.* )v\ 6.' <br /> ri <br /> N t4 54� y <br /> oW� cow1/4 �.5•0* OJ`« `0y -)'b°I i Fee Rec: /�r`� <br /> S�R& wow), °z Check#:yzio <br /> rn <br /> m <br /> v <br /> w <br /> Date of staff site visit: C h1 11)-i Initials of site visit staff: GI— a c <br /> APPROVED BY LAND SERVICES OFFICIAL: Viiitait LINO DATE: -7llV <., = 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 723, 3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Pagel of 5 �L .J <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />