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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> < - b <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and fees(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 I� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° C <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 N <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 . <br /> -o <br /> *Communication Towers,Camping Permits&Signs require a different application form,see corresponding application,and fees.NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: Da i D M <br /> n � a <br /> Property Owner's Mailing Address: (��St 5 1A1-aVE-1LU1M6VD Ij I R. <br /> „ City State Zip <br /> Property Site Address::3 �t LCR- 1-ME <br /> r <br /> o h <br /> Contact's Telephone Number: (651)� 4$ - —S 40 N d <br /> oo <br /> Contact's Email: D��V S Co (;0 m <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov Q0 <br /> �1 5' <br /> Legal Description of Property: L 0 I / CSIA gbD g VIOL A9 P <br /> Section#:: Town#: j�N Range#: lu� _W Town of: S W <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 3 5838 I" <br /> Proposed Use of Structure/Addition: AAI 6G c o0TN 0EF- <br /> Anticipated Start Date:_ (Home/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> En <br /> Building Contractor: Ai i A Sewer Installer: N1 f} <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: > <br /> m <br /> \w Fee Rec: <br /> �S B(rce,Q C u ►n � � �� 1lL�rriGu'� �G,�j i }fl.�� <br /> 1 O I . . k I•aq 0 V Check#: <br /> v 'V YJLu oh J <br /> E� <br /> m U <br /> d r <br /> Date of staff site visit: J! 5 Initials of site isit staff > co M X n� <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: ZvZ S <br /> m w <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o <br /> "o = N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> Page 1 of 5 U <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />