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LAND USE PERMIT APPLICATION— Burnett County, WI gr `A <br /> ,G. r+ 1 <br /> Applicant Complete All Sections Below This Line a <br /> Permit Types and Fees(Please,check appropriate boxes) da c, <br /> xDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ' —4 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \N p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G? Po <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 . °< 4111, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C" <br /> 9 <br /> Filling/Grading $150 Boathouse $500 c 114 <br /> m <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 a <br /> E <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. r r , <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> 11 <br /> a <br /> Property Owner's Name:PI 4.J(4--.A L ct Ac jito=h e) Z L c., (Dw <br /> N /oeyo 73=1- i 18 F� ' NL) lHovt.- inIN 3 30 i .o <br /> o. N <br /> Property Owner's Mailing Address: ?. 0 k <br /> City State Zip k, ,� b.. <br /> Property Site Address: C-9 72 5 T/}T f2 6 7 0 i.,.y 6 6 S le 2 L.i 5 'f 6 4 3 0 <br /> Contact's Telephone Number: 74,3 — 3 5-00 --27/ "7 rD <br /> r. <br /> Contact's Email: 4ctei. 0 inklt<<r(4 Zoe k,t_h oon es , G c,^'► F; <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ro - <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov °. `� N <br /> Legal Description of Property:LOt/ Ca" /?Ito V 0,-6 go90 RPGr4er'i 45 duc...% e., )1-.3 2 d 0aq q �' <br /> 44 Section#: 94, Town#: 3`� N Range#: /E W Town of:/ne'en...a f3 (`v <br /> • <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 0.Tax ID#(1-5 digit number; found on tax statement): I a 5-1a x <br /> a <br /> Proposed Use of Structure/Addition: Ho Al e .-3 —`" <br /> Anticipated Start Date: /4�y v.5 fr 3 ©� 1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) `�' <br /> Building Contractor: v 4-4-'1i eft Sewer Installer: licoP 4 +^..2 (J) <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 /> 0 <br /> 0 MCC-1- ad 5- - --5 <br /> c- <br /> 0 ‘btiot,CJi.no) ao-\-- 40 tYc-e_tcl Li becbrooy-n lok,r spv\i_zy..2_06 „, <br /> Fee Rec: , <br /> ° Check#: I D 2-7 <br /> z <br /> r <br /> z <br /> n <br /> it <br /> v : <br /> Date of staff site visit: 0 Ilk) �2� _ Initials of site visit taff: T. a Q <br /> APPROVED BY LAND SERVICES OFFICIAL. ATE:QYSOfrOZ43 <br /> 0CDUPON APPROVAL: APPLICANT MUST POST COPY OF 'o _ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT D - C' <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 04/2024 �- �7 <br />