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CD <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line S cwNi <br /> a <br /> Permit Types and Fees�Please,check appropriate boxes) (}1 <br /> Dwelling/Principal Structure $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 ^ CD <br /> Accessory Structure(Commercial/Industrial) $2 00 Addition/Alteration to Bunkhouse $150 ~ <br /> 0 O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °<�- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 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 /> -o <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. <br /> z� <br /> 0 <br /> # C i(G e ��lb� 0 1�PropertyOwner's Name: ,.. ..r-�� <br /> Property Owner's Mailing Address: O © fog n j <br /> City State Zip <br /> Property Site Address: Qt�c/"fc� /r i Snort �� (.d.L 5 4At o <br /> Contact's Telephone Number: (n{;Z 'A�/f 4 /CS OT? N a <br /> Contact's Email:_' <br /> **If staff has a questi n 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 °Q -0 <br /> Legal Description of Property: l o� / EC�'Si�► Tic. { �ie►crs ,�ef 5-VA O/ <br /> Section#: 13 Town#:_ (: N Range#:�W Town of: Spy <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): <br /> 0 <br /> Proposed Use of Structure/Addition: H j!"4L 4bi r, 3 <br /> Anticipated Start Date:- q,;?n=2 (Home/Cabin:Commercial Business:Bedroom:Deck:etc.) <br /> Building Contractor: nK (_'�� sq AC Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z v <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: zz X <br /> Nod- A ,,,A-5 � eve sati/>&�y 2-5- 77 <br /> ��� �� CI�� ts�e��i" o�74/h �N ,0er ►�7�; D OD <br /> / Fee Rec: 300 _ <br /> ° Check#:�. <br /> z <br /> r- <br /> z <br /> m <br /> m <br /> m <br /> O <br /> Date of staff site visit: 919 2oz,- Initials of site 'sit staff: (� <br /> c� ,n CC D APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF0 <br /> _� <br /> fD c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Pagel of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />