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CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a ro <br /> Applicant Complete All Sections Below This Line ' <br /> a 1 <br /> Permit Types and Fees�Please,check appropriate boxes) C <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 NO1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> �y Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> M <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r' <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -o <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 1D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 ' <br /> Z <br /> GI ° <br /> Property Owner's Name: _ � t r,1 �� A-- �� �� a �L� 1�(� VIj <br /> 0 <br /> r. ►3�r b <br /> Property Owner's Mailing Address: � � C{ G ��-4-+2 r � r'15 Vr��� m tV 5533 - <br /> TA;* 11> 7 S 2 7 f City State Zip <br /> Property Site Address: I + + t ' eyye r t a n Sk V,I F,C I l�e 1.,S 1=c n, S o N <br /> e <br /> Contact's Telephone Number: 5 0-1 — Z 1 <br /> Contact's Email: 9c>n k'f—' L-.t''1 kn Cit.'I C t, <br /> **If staff has a question about this application, will 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 R. <br /> °Q <br /> Legal Description of Property:L-O+ ye r 14✓1 AM'Q i+"o n 4D VOy Ct e r 31 <br /> Section#: 2?j Town#: L AN Range#: 1 S W Town of: ck CICS� V+ l 1- J <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o w <br /> Tax ID#(1-5 digit number;found on tax statement):i—4 3 Z ` —1 2 2-6 W x <br /> _ i7 <br /> Proposed Use of Structure/Addition: ke5l to <br /> Anticipated Start Date: t{ —( — Z o Z S (Home/Ca n;Commercial Business;Bedroom;Deck;etc) <br /> Building Contractor: NJ Sewer Installer: IV 4A. co <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Z o N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x Z <br /> ✓YI Cr=T ACC 5E rgACk5 <br /> AX-V Tb BE ts5Ep FOR I-lQVLA n HAi31 tAT�WN. <br /> Fee Rec: � <br /> Check#: 1003 <br /> n <br /> Date of staff site visit:3 S Initials of site visit staff: a� <br /> ro a � <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 I DATE: 3 L9 zo25 moo <br /> < <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N <br /> 00 Q <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 C <br /> Burnett County, WI Land Use Application —Rev 04/2024 �� <br />