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, - , LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line a' <br /> CD i <br /> Permit Types and Fees(Please,check appropriate boxes) a. <br /> d <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 cam, <br /> C1 o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150, 4- '.--N a <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° O '.\ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 t <br /> Filling/Grading $150 Boathouse $500 <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 R. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. k5 <br /> ro <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. 0 C . <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. - , <br /> 0 <br /> Property Owner's Name: D/y Li Ge /� o <br /> Property Owner's Mailing Address: 7f 2 V `'1�t5 ree Il / N t 5'(re � 1 n <br /> Property Site Address: '-f 0l? 5 �tiiCe/' 'LI e jo�/ pt�t! tA:7,. <br /> ip��7 < <br /> Contact's Telephone Number: fp /2 — O,� ! — co aO ° <br /> e <br /> Contact's Email: Tio y L L . t .S°t_ ,5 i'i c 11. C.O I <br /> co <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following�ad/dress: @BurnettCountyWI.gov 0 00 <br /> Legal Description of Property: Lot / GSNi g a 7".2Z( f' Pc 6ehic.GI1 /1 q, 4 / 1.ern d(oN <br /> Fr /l r 7/� 5. <br /> Section#: 2 Town#: 3 � N Range#: I c W Town of: o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* N <br /> qg r Tax ID#(1-5 digit number; found on tax statement): [ 2 t � t7 <br /> Proposed Use of Structure/Ad itio : �J ti lit H <br /> Anticipated Start Date: /O///Z y (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 1 ` <br /> Building Contractor: j C"1 SC 6'1 Sewer Installer: n <br /> H <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY trlo 'O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o N <br /> D Aiet L 6e. use r i►uw+41 ha4/74l4o`f, < v1 (' <br /> c t 4 be_ /03 74��a/oil �c. s 04L 74/f� Y m _ <br /> 2 f)' ex Z Fee Rec: �J <br /> i Check#1 ,- 6 <br /> m I <br /> ' v <br /> Date of staff site visit: /O/3/20a s/ Initi is of site visit staff: �/� a n capFril <br /> .i cn <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /0/7/?4 LY < 3 <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF o o :1-1 <br /> ..CD C N, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTMI I <br /> n <br /> Page 1 of 5 ►TI I <br /> Burnett County, WI Land Use Application—Rev 04/2024 �--� <br />