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jA <br /> F , LAND USE PERMIT APPLICATION - Burnett County, WI a ro <br /> < b <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and FeestP/ease,check appropriate boxes) ° ^j <br /> le <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 9� C) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 b <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 1 lBoathouse $500 <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 /> ro <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 /> z <br /> 0 <br /> Property Owner's Name: c KE(LFfi o <br /> r nr n- ` - •o � <br /> Property Owner's Mailing Address: 2� E• �+� T� �KR�lts�t3Q .r � n <br /> City State Zip ° <br /> Property Site Address: SH rVAi; o N <br /> CD <br /> Contact's Telephone Number: <br /> I LL C7 <br /> Contact's Email: )<e j i E, i?" ►J T 5 6 v i;^ TC� C b ` <br /> **If staff has a question about this application,you wi 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: @BurnettCountyWI.gov °0 <br /> 5' <br /> Legal Description of Property: Sc G)C s e 3Zt <br /> b <br /> Section#: S 32 Town#:T L2>9 N Range#: k W Town of:WET MHM-14 LAND ' W <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Cn <br /> Tax ID#(1-5 digit number;found on tax statement): 2--5 5 Z W <br /> !Wv F <br /> C7 <br /> Proposed Use of Structure/Addition: CAte 'PORT- 7 <br /> Anticipated Start Date: S60 f,3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -�— <br /> x <br /> Building Contractor: 6 F-« Sewer Installer: IQ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> v � <br /> U Mee,+ off. w wo s X CIV <br /> f �"uow W,440 <br /> < <br /> a t� and (�'`CU 5 Fee Rec: <br /> 4Ui lid 4o �e Yklured At z Check#: <br /> m <br /> n <br /> m � <br /> // � o <br /> Date of staff site visit: /� L2027 Ini"ofsiteisit staff:` yyT.i- b SCD CD <br /> Z <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: I i2 <.CD <br /> CD <br /> CD n oy <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFCD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ro <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />