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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This LineCD <br /> uNi <br /> Permit Types and Fees(Please,check appropriate boxes) a ° <br /> G <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 � <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk IBunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> o <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 construction has begun)may cost up to three times the normal fee. <br /> -u <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: AkyA A ytyk, <br /> Property Owner's Mailing Address: 3,15(0 L L&V,t ' )0►0)[f <br /> n <br /> City I State Zip <br /> Property Site Address: kS L o L A A& o N <br /> c <br /> Contact's Telephone Number: %5 - 416 - L i 3 d <br /> Contact's Email: yit r'A�✓e (6- Q VVAA 1 e &.0 1A <br /> **If staff has a question about this application,you will be contalcted via email. Make sure your email address is <br /> legible and your email provider will accept emiiails from the following address: @BurnettCountyWl.gov °Q <br /> Legal Description of Property: y N V1� S�I ( �,�T t 1 es IA Pao <br /> Section#:/I Town#: 3 C1 N Range#: Qf} j W Town of: ("z w" <br /> *Attach additionalpage if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): 1-15 13dtF <br /> Proposed Use of Structure/Addition: 6-4 Q C 0 S U Q 7 t41-w i a <br /> Anticipated Start Date: iA ml7 V*11 it 111 (Home/Cabin:Commercial Business:Bedroom:Deck: <br /> x W <br /> Building Contractor: W14t�'O f Sewer Installer: jJ , <br /> AREA BELOW THIS LINE FOR LAND SERVI S STAFF COMMENTS/CONDITIONS ONLY <br /> r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> ©Arts+ apt &t+baJ5 — <br /> ha.b�-Ea,�i�n <br /> Fee Rec a� <br /> z Check#: <br /> VC al� C �A Ut Pel(M'1+ GUP 4D Ike obfaitud 4Dr 4ttt Wl�cti <br /> ac, ivi-keS lob ���'I2D25 <br /> CnW <br /> Date of staff site visit:3 [Q 2(�ZS Initials of site visit staff: � A <br /> APPROVED BY LAND SERVICES OFFICIAL. IJ� / � DATE: 3 C= <br /> r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 73 <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 ------� <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />