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CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI <br /> s' y <br /> Applicant Complete All Sections Below This Line A <br /> Permit Types and Fees:(Please,check appropriate boxes) •:.c- 1-_-_,- S." <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 p <br /> •/Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 W` <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 r. <br /> Y, <br /> Filling/Grading $150 Boathouse $500 <br /> C <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 5 e <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. 0 , <br /> Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c a <br /> • <br /> / o <br /> Property Owner's Name:(74/y CD/` .3;4A.J: LOI—].MP <br /> Property Owner's Mailing Address: P 0• &X //e2- iDf 86 727 Q LU/ L/99 3 T. <br /> City State Zip ' <br /> Property Site Address:o29 3 7 /A/,QA/5CoN) L/9kF TR2,/,,\/ b1ML /rey; /I)/ �" <br /> ii <br /> Contact's Telephone Number: 7/5" �o/ —/6 .'�'`� <CL-,4,//--,.7i2iV�'� `j�61 c) o ; <br /> Contact's Email: Lo1-/A 2/9//_5 @ 614q/e)/L COA4 D <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,..� <br /> legible and your email/provider will accept emails from the following address: @BurnettCountyWI.gov,.. 9 � "' <br /> Legal Description of Property: v /2.. FR 5i ) St City 5M/vT�'33co c-VJ N <br /> Ci <br /> Section#: 06 Town#: N Range#: /1/ W Town of: C.2 ]-r N <br /> IN <br /> *Attach additional page if needed,for lengthy description OR attach a copy of the deed OR attach tax system property page.* CA <br /> ,c,H-- <br /> W Q ° x <br /> Tax ID#(1-5 digit number;found on tax statement): / 7 02,7 6— <br /> Proposed Use of Structure/Addition: �j'7/� /� �,f��,� H <br /> Anticipated Start Date: v,1/o%�y r omcCabin;Commercial Business;Bedroom;Deck;etc.) -{. <br /> Building Contractor: Sewer Installer: N CDN <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY mez o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z x <br /> nitik4 aiti Sk-l-loac,ks tr, <br /> m <br /> Z Nod- 40 ix ttstd -fo,- i'VWmcv <br /> [f�//,, ,�- - ,/ Fee Rec: �� / <br /> CI '!'1/LG/f 30 �f /h a C� � 7 / ° Check#: s�.r'i / <br /> G0.x ,r Ylo-� -� �2 uSec� wit .< <br /> 70 <br /> m <br /> Date of staff site visit: Mb /202q Initials of site isit staff t 6 ci) it <br /> Eta) rn i0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /D/3/202 <.c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTg. <br /> CD <br /> Page 1 of 5 L.:` J f <br /> Burnett County, WI Land Use Application-Rev 04/2024 <br />