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treat rei-t ,,,- N b r <br /> . LAND USE PERMIT APPLICATION—Burnett County, WI e <br /> . <br /> Applicant Complete All Sections Below This Line 0CD I <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> d ' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 cvo <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 J 0 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 <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 S r <br /> Filling/Grading $150 Boathouse $500 • <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 e <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S z <br /> 9 I: <br /> Property Owner's Name: i`} ," T_ (2 ),u p V to <br /> Property Owner's Mailing Address: J/33 � AY T T2)� A ) .54 3 <br /> aE � � <br /> z State Zip <br /> Property Site Address: /3� /tA) 1oA- =4 <br /> ? N lib <br /> 6A i9W1 oel7 •• a <br /> Contact's Telephone Number: A n d II <br /> � <br /> Contact's Email: c`p /-10e9 4t5,L��Az-►��� �I, t., <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is , b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov .e d° <br /> Legal Description of Property: A -,61-) —IL) d <br /> Section#: 00 Town#: N Range#: /e W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* (I' <br /> �) QQ�� N c <br /> Tax ID#(1-5 digit number;found on tax statement): GC-3-/� 2 o <br /> Proposed Use of Structure/Addition: bmlPr6: a 1V <br /> Anticipated Start Date: q q—A"! (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: 5X2,f Sewer Installer: a r4 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i 'z r <br /> 0 NO+ -I-0 la.e_ ultd -Por kwrritt.4-1 ko_10 i-i-fx-fibi VD <br /> ri <br /> (tM.eei— k4-ba Lk.s tri <br /> ,, by 4/ls� iii <br /> ; 1 <br /> c + Y�.k 1 i dS 4 Secured a Fee Rec: <br /> @Carp(1-1Chfid aid �� cc {A,i ner �o be rerno�d or I-�' lot/ ° Check#: (/a5/.� <br /> -/ ji S per'1r4- ex f:r 1- /1 5 7/2(Q f 2O 5 A ��� <br /> ,,yam,_ w rLThfl <br /> —7 25 2 ozq Initials of site visit staff:' 1 v)ca <br /> Date of staff site visit: 1 '7 C <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:7��,Ur j?.02y y <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> K <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a <br /> = I LM <br /> Pagelof5 JJ <br /> Burnett County,WI Land Use Application—Rev 04/2024 <br />