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a CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI cr <br /> Applicant Complete All Sections Below This Line ' <br /> Permit Types and Fees�Please,check appropriate boxes) M 1 <br /> d <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 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> d' <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures 3 c ) <br /> Filling/Grading $150 `: Boathouse $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 cons -uction 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 strt,cL.-es,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: Yq�ayj htS — L sx-11 c <br /> / <br /> Property Owner's Mailing Address: � (--4 .m/V <br /> ty State Zip <br /> Property Site Address: 3/05o2 61-)4 <br /> c <br /> Contact's Telephone Number: 5-0-7 - 5 7/ -d Y5-6 ° <br /> N d <br /> I <br /> Contact's Email: L Q14 <br /> **If staff has a question Jbodt this applicati ,you will be contacted via email. Make sure your email address is § N ro N <br /> legible and your email provider will accept emails from the following address: @BurnettCouu'ntyWI.gov 0. °q 4 <br /> Legal Description ofProperty: tot' CY ►t 633 lG1- t 2- /V4�1� <br /> g PV ( <br /> Section#: 13 Town#: L( ( N Range#:_ 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.* r� <br /> 22 N o <br /> Tax ID#(1-5 digit number; found on tax statement): J L{Q-/L d <br /> Proposed Use of Structure/Addition:�; /�z -tij <br /> Anticipated Start Date: (Home/Cabin;Commercial Busin ss;Bedroom;D ck;etc.) L <br /> ILI <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Iz <br /> D doll r U re nun+5 (f Sl��r�l u r►� rP S f o ru I i a� ay�r�rr�►1�- Ics <br /> Fee Rec. <br /> LQ►b,i� Gt reK (�l �l I I l �" 7� GI C °z Check#: 1119 <br /> �35o tt�2 <br /> tz <br /> Date of staff site visit: �IInii/ti/als of site visit staff: L �T <br /> APPROVED BY LAND SERVICES OFFICIAL'/IG�1 -/',/ ldw, ,w DATE: <br /> w <br /> cn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co �? <br /> CD <br /> fir <br /> SIGN :Iy PLRIe✓IIT APPLICATION IN PLAIN SIGHT 00 <br /> a <br /> Page 1 of 5CD <br /> C <br /> Eurr.ett County,WI Land Use Application—Rev 12/2023 �� <br />