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LAND USE PERMIT APPLICATION—Burnett County, WI rr 9 <br /> Applicant Complete All Sections Below This Ling <br /> CD I <br /> Permit Types and FeesiPlease,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 R <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/industrial Structure $200 u <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <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(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <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. <br /> b <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. S <br /> z <br /> 0 <br /> Property Owner's Name: Rrian and Mary Mann N <br /> Property Owner's Mailing Address: 7qc /1� E. <br /> City State Zip <br /> Property Site Address:3039 C.ni rnty Road A o <br /> Contact's Telephone Number: 76.1-3(0-6.362_(Brian) b — <br /> W <br /> Contact's Email: Rrianmann76SIOgImail cam <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 address: @BumettCountyWI.gov <br /> Legal Description of Property:y:�OVt LOf L Lol, J CS143P27 660e�t: lt <br /> Section#: I tltl d <br /> � <br /> Town#:�4 y N Range#: /4/ W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> N o <br /> Tax ID#(1-5 digit number;found on tax statement): 19Z 7 to <br /> Proposed Use of Structure/Addition: 3season porch <br /> Anticipated Start Date: Pnccihle winter 940R weather (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: iynrthland Sewer Installer: Q t- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z X <br /> X <br /> -t -mecd 2 Wrotms per S�►v��c�Zy� � �� <br /> C <br /> �)Cbn4tu+ Rkii-for ► Df�' 5 COO(4 C(rl�/ I�"W T01� Gay e k#:� <br /> gtCfs1a✓`� / heck#: /3!!9 <br /> z <br /> Date of staff site visit: 2 1 2D2q Initials of site vi 't staff:-l�T D D vz co g nu u <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: Z 3 [27421-1 `=3 <br /> m c <br /> UPON APPROVAL: APPLICANT M ST POST COPY OF c'C= /J <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD �—�M <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 04/2024 <br />