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LAND USE PERMIT APPLICATION — Burnett County, WI = r <br /> r <br /> Applicant Complete All Sections Below This Line Ut <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ^ 1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ear <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 < X <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 — <br /> Filling/Grading $150 Boathouse $500 <br /> �n <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> a <br /> `NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <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. b <br /> z <br /> 0 <br /> Property Owner's Name: L x `� <br /> Property Owner's Mailing Address: tl t'e A I pok wcz F le y al n <br /> tt i r f � City State Zip <br /> Property Site Address:!{31 L SI t�VllCil 1 T�rr�� of S)- C,�r" w_ <br /> Contact's Telephone Number: <br /> 0 <br /> Contacts Email: r7 e m e-r C- 'q nws (y!14 h041 c c31yV <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 4 <br /> legible and your email provider will accept emails from the f lloyvjngddrrs��.Burnet ougtyW�, <br /> Legal Description of Property:* ©7 I `{ ! oZ z. S /3 7� DODO <br /> Section#:�j,�Town#: q _N Range#: /S� W Town of. e kS U jr1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax s1•stem propertti•page.' <br /> Tax ID#(1-S digit number; found on tax statement): ff-3 L oZ S <br /> Proposed Use of Structure/A di 'on: r ric_ +fir ear per <br /> ct►vt o D C'1 <br /> Anticipated Start Date: ! (Home, Commercial Busine s:Bedroom:Deck:etc./ <br /> Building Contractor: Sewer Installer: <br /> AREA BELO«'THIS 11XV OR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: X <br /> Si rlc� /1d Saln r'Av�1 SyS ^" exIS75 /�t CC,J%Ap P.>v' i1 eR�S 7� je <br /> N�S Sp /!�l►i s G ��e, 4//d Ij � C,;, uAPP.N MIMOVq /a t Fee Rec: <br /> /! z Check#: <br /> �x�•cT Uoya9e-►^ V/�149e � s e.e. i� �i� req u/Nc., a ��ckAl/; <br /> M4/kE <br /> _ //-- I a e 30 Fr..-x t o iroct ►At' 1 o <br /> D SUY�7*� 6 <br /> t-J aye <br /> Date of staff site visit: Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> (n p ram\ <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF <br /> oCD c o <br /> SIGNED PERMIT APPL_I_CATION IN PLAIN SIGHT 3 N <br /> Page 1 of 5 CD <br /> � S <br /> Burnett County, W1 Land Use Application— Rev 11/2024 <br />