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RI <br /> LAND USE PERMIT APPLICATION—Burnett County, WI cr @b <br /> Applicant Complete All Sections Below This Line c A <br /> a. ' <br /> Permit Types and Fees:lPlease,check appropriate boxes) ,>- d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v 9) <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ o <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .4 A <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 N <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 D' r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c . <br /> Filling/Grading $150 Boathouse $500 vi <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. `� <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. ,- - <br /> o gProperty Owner's Name: �EN—L- R• C���...�N C Z �8' <br /> Property Owner's Mailing Address: ii.e ` , i 5 e ��.� Ct�txiitvia k}S Pig-, �. <br /> �]�J 4' f City • Stilt Z c <br /> Property Site Address: 1 'I plc 6l e s I c -I'l(i ' -Rt - i l�t t.4,./k P�i �?C> Z c ,.F <br /> Contact's Telephone Number: / t‘`J ' 11 a 41 j 4; a. <br /> d <br /> Contact's Email: 5 Yi e-) i v fy\o—, \ ' C Ca Iv\ _ g <br /> **If staff has a question about this appli tion,you will be contacted via email. M ':e s-1 ,.your email address is N 'V <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov <br /> o r <br /> Legal Description of Property: g- <br /> ,, <br /> Section#: 12).2' Town#: 41 N Range#: I W Town of: 41-;'i S. P. N <br /> *Attach additional page if needed for lengthy description OR attach-ZL--a�c7opy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): _ (`) <br /> Proposed Use of Structure/Addition: GYkr. 4 . - - , C'C)3C L-`C G i---)42—I'J (', <br /> Anticipated Start Date: '(•- ) -;i4 (Home/ n;Commercial Business;Bedroom;Deck;etc.) ` <br /> Building Contractor: �U i2t-` CL t,(-`C%L_ Sewer Installer: y <br /> AREA BELOW THIS LINE F R LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 0 <br /> ' (A, . C�;-E;cool 3 Skea-low -b -Ciron-k- �rt�pe.r�y l i Knee t <br /> n <br /> ►\)eF1vbe. l ' y <br /> Fee Rec: <br /> _15%- <br /> R Check#: <br /> .e <br /> M <br /> n <br /> m <br /> I v tv <br /> m ' Jl Jl <br /> Date of staff site visit: CoJ1IES <br /> 1,1'i 4' [2-cliz q Initials of site visit staff: GL 'i' K.I _ 7....... <br /> �� <br /> APPROVED BY LAND OFFICIAL DATE:_//�7/ZL9Zy co.i a W �'` 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y <br /> oa � <br /> me c , <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 2 <br /> ,(tf <br /> Page l of 5 L� _J <br /> Burnett County,WI Land Use Application—Rev 04/2024 <br />