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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> � C <br /> ti7 <br /> Applicant Complete All Sections Below This Line - A <br /> Permit Types and Fees�Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 gj <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 `— <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> 'I. <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 /> -c <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 /> Property Owner's Name: ?AAVN w i v <br /> Property Owner's Mailing Address. 3350 N(jqt., ` Dr M <br /> C • State Zip <br /> Property Site Address: Axno D& ,,n R-1 < - <br /> Contact's Telephone Number: <br /> Contact's Email: /°1�CaCw ,n 27( zze6 &&!mOw�d- ►�� <br /> **If staff has a question out this application,you will be contacted via email. Make sure your email address is _ <br /> legible and your email provider will accept emads from the following address: @BurnettCountyWI.gov <br /> Lot, cr�C~y P 3a6 T w — <br /> Legal Description of Property: D? 40- N-R-5 OS-Gt� -(�1SGY73(L� <br /> Section#: L Town#: 'rSL*) N Range#:R J 4W Town of: S = LP <br /> *Attach additional page ifneeded.for lengthy description OR altach a corn of the deed OR atlach lax s.vvtem property page.* s <br /> Tax ID#(1-5 digit number:found on tax statement): <br /> Proposed Use of Structure/Addition: a <br /> Anticipated Start Date: —f' s rllume Cabin:('ommerciul Business:Bedrexrm:Deck:etc.) <br /> Building Contractor: Sewer Installer: O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> -bu.Cj--S x <br /> [-0- u it d 4 r 6m aAn 6-6�' <br /> T Fee Rec: <br /> Cfollow m4 chayls —rrw4 d 69 ry DA,% fee ri lln4- Check# <br /> J <br /> G�c,� u�� C.�tu�n ��� d -I� Secct,r� �.ep�►� fcr v�k lid by 51+1ZoZs j M. <br /> I ME <br /> Date of staff site visit: I 2c)2 Initials of site vi it staff:CKr <br /> y <br /> APPROVED BV LAND SERVICES OFFICIAL: DATE: II ZI120M <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c A <br /> Page I of 5CD <br /> r <br /> Burnett County, WI Land Use Application— Rev 04/2024 <br />