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J ' <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a r. <br /> b <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees�Please,check appropriate boxes) Lca. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure -$200 C� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° 91116 ''I. <br /> Driveways/&Campground Structures C itt y pg $125 WI State Statute 59.692(ly)Structures $350 0 P <br /> Filling/Grading $150 Boathouse $500 '-{" <br /> cr <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 3 <br /> F, <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -o <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> r 2 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o z ri <br /> 1 0 <br /> Property Owner's Name: TREtJT 4 s mut. • ""%..&bI -r 6- <br /> 0 <br /> Property Owner's Mailing Address: 11 [Ekc IJ * pc''�& °c�' O� t4,10 SSIZ} _ r <br /> City State Zip 4 O <br /> Property Site Address: a34-.36 S‘Nc-1)i t te•4 V W ebs{'cf w i r4$43 "Z < <br /> o N <br /> Contact's Telephone Number: 6, 1 Z 5-9I -3151 o <br /> _ fl <br /> Contact's Email: ARE A-rSv.D L e /A.rr00. ComCD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N -o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 5 40 N <br /> -C <br /> Legal Description of Property: ?L bt Jkay GIto3 Lor o P <br /> 7,.. <br /> Section#: a� Town#: 4 D N Range#: 11" W Town of: Um i0,..) NL <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* v <br /> Tax ID#(1-5 digit number; found on tax statement): 0253.2 S.- 1A F x <br /> 0 <br /> Proposed Use of Structure/Addition: e.as Zr/ H C, (�► <br /> Anticipated Start Date: 09- 04-ZO2.`( (Home Cabin:Commercial Business:Bedroom:Deck:etc.) -L 9 <br /> Jet <br /> �� r -,' `Toss TI(a.)d� <br /> BuildingContractor: �C Son COo��'ft•t, O Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z <br /> b MRek aiu Se. arks c J <br /> no+ tGCetd 3 S p Si Zy-17O m <br /> C <br /> Dbuo-t k:n M4 -1 t)(cQ.Zcd qo-p \ Q;, k-k' VeS c-hbYI Fee Rec: CO <br /> ©f -Fu�+(� �n' Y ►mc�-+�1 cu+i� or c, 5es I.,� <br /> It re (.4..1 it revt�'"' Check#: 2 Li 3 <br /> ( <br /> � („vkcx <br /> (Ul�,-I S Su lr rt c.L arty +S. CoftvlAA be U - 6r m <br /> lJ � k '�St IS SI -+n as a ShQ� on �eVtCs.xSuma� Inuaoi ka '1 0 l ) <br /> C r <br /> Date of staff site visit: 7/241/10 Initi Is of site visi taff: GLkT H 4 51' <br /> ifEl <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 2-V CD �° r- <br /> � 3 r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N a '" nit <br /> 0 o n <br /> CD C N cV r�,0^ � <br /> � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT u <br /> C <br /> CD <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application -Rev 04/2024 �L JJ <br />