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LAND USE PERMIT APPLICATION—Burnett County,WI rr ro <br /> H <br /> Applicant Complete All Sections Below This Line ; <br /> 6 <br /> Permit Types and FeesfPleose,check appropriate boxes) = C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <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 ;l <br /> G� �v <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(iv)Structures $350 0 1 <br /> n <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) 1$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. N <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. a <br /> t h o_ <br /> Property Owner's Name: Riu<q <br /> a � <br /> Property Owner's Mailing Address: 1't;'S O 5- L.T <br /> City State Zip <br /> Property Site Address: 2'7 2 i v LD Le <br /> CD <br /> Contact's Telephone Number: t Z - "1`t I - S f L: c Iv <br /> uh <br /> '~ <br /> Contact's Email: r-^,x ct z r s , �. °•"c <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ro ^ <br /> the following address:@BurnettCountyWI.gov <br /> legible and your email provider will accept emails from °. <br /> Cat o ov <br /> Legal Description ofProperty:PKT LOT S cStrill L}59�1 d s p3 L';L- ,.1 o,akL, TwvsNP O q. 7�73 v W ' <br /> Section#: 31 Town#:"•^''lv N Range#: <br /> R 1 Ic W Town of. 0 PW C A-N n � <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> w � w <br /> Tax ID#(1-5 digit number;found on tax statement): 3 z o ~ <br /> r7 <br /> Proposed Use of Structure/Addition: P,;,,) t�•1 <br /> Anticipated Start Date:�5- ii- �?5 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) N <br /> Building Contractor: "Ar..o.su,s Sewer Installer: tnla-ca- OuF 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <br /> (0 Mus+ mkt, W se,-l-iouc,�s <br /> too+ -b CXCeed qbk- - hf res-Fly�+;�n r <br /> ceed -25-®bVOUIno- � ex3eX s?CN-» nNPP 1y <br /> C,' (,`° Fee Re': <br /> r 15°To I rvl f V1 WS ki'v L-• z Check#: <br /> 56Lra% 4o be R MOXd U,nr,� b t <br /> 1 <br /> Date of staff site visit:��71(17�S Initials of site it staff: L- e(-j o c_ <br /> APPROVED BY LAND SERVICES OFFICIAL. Y`�DATE:5 �2, S b � � � <br /> CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> CD Fn <br /> Pagel of 5 <br /> Burnett County,WI Land Use Application—Rev 04/2024 -----� <br />