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LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> Permit Types and Fees�Please,check appropriate boxes) b <br /> Dwellin Principal Structure I $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 <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 /> 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 /> W <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form,see corresponding application,and fees. <br /> h <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> 0 <br /> Property Owner's Name: etqMp G'RD j �Qr��t�T/O IN r✓ o lV <br /> a <br /> Property Owner's Mailing Address: 80,E 1411OL� 1/t RY•. Dtf L14 TIC M IJ 56 V I <br /> City _ State Zip ° X --O <br /> Property Site Address: 1qq- CD <br /> C <br /> Contact's Telephone Number: v2 <br /> d 1 <br /> Contact's Email: 01 � � r' ('a't3`I��'IT/�C Cd r <{ `° <br /> **If staff has a question about this application,you ill be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov = °° <br /> Legal Description of Property: C V52N)1 Elm ITS A 3 v <br /> Section#: 10 Town#:73V6 Range#: A W Town of: 5 G0—Fr <br /> N <br /> *Attach additional page if needed far 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): d d <br /> Proposed Use of Structure/Addition: 9WOEle-e11-�L— <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 41 vv 0 <br /> Building Contractor: Sewer Installer:k% 6 R44F!�HKL,44 O <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS L STEI) $ELOW: �, p <br /> �nI's to v,1;7L 1S -6o'r -�Ae. Y1 vv,to I>'i I u ,^�po�� u�'///d�jt � , ✓e�oc4 Vl <br /> e- �-7 ca �/H5 civt/a-�- eKP aK �in� �P4 t�J <br /> is DeAA, W. <br /> i f IMC�u�h ct oHe- yepr' P�C�-(110 � P��' / /QO�Eo <br /> / Fee Rec: <br /> 0 Check#:t4;0� <br /> a ForloLo q�► <br /> Date of staff site visit: O ZD Z S Initii Is of site vis' ff: l y '— <br /> a � <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: m Co 't7 <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF < �- <br /> CD <br /> 0 �I <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT � a <br /> Page 1 of 5 CD <br /> Burnett County, WI Land Use Application—Rev 11/2024 �� <br />