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LAND USE PERMIT APPLICATION — Burnett County, WI 0. L...., <br /> E: N <br /> Applicant Complete All Sections Below This Line o c w <br /> Permit Types and Fees(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 n 0c <br /> Commercial/Industrial Structur* &M $300 Addition/Alteration to Commercial/Industrial Structure $200 ��J -`, <br /> '1�c�` ' ^\ O <br /> Accessory Structure(Garage,Shed,etc.)V n Addition/Alteration to Accessory Structure $150 W <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° Q_ V <br /> r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 L. <br /> Filling/Grading $150 Boathouse $500 ' <br /> Solar Panels(Stand alone or roof mounted) $150` Permit Extension(1 Year Extension-Allowed Once) $100 2. , <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. ,& • <br /> ro <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 /> oi ' <br /> Property Owner's Name:_ Jock ht 6- Q.(V.t.( — o `I <br /> 0 <br /> Property Owner's Mailing Address: 211 fAitu n we Off,t PLk7� -4 y..-t r'�ll`1 S SL L' F. <br /> City State Zip <br /> Property Site Address: iocicoLL , ,v <br /> C'' C J""�Contact's Telephone Number: q5c 3as n <br /> - IC7 <br /> Contact's Email:„ear k -! (4(.5 op sena, I I . C.L1Yy I' <br /> **If staff has a quen about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and o <br /> oo. <br /> °0 <br /> @BurnettCountyWl.gov go <br /> j d <br /> Legal Description of Property: L Di *t 1 004 t,-+f iSpCri l "Pnx.( a cf 11" Let LA9 3• <br /> Section#: I/ Town#: . .1 N Range#: I W W Town of: rfi)Cell I.. VI <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> , C <br /> Tax ID#(1-5 digit number;found on tax statement): �.D_S.3j 01 <br /> p '4 kA.,.0 ( sift.,,( w <br /> Pro osed Use of Structure/Addition: ck <br /> Anticipated Start Date: Dt P— (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) .).1CkC- t <br /> Building Contractor: Rik Sewer Installer: fJ OA - ) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> LTHIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Crt.t5i- ,iraccf 4 II subs, cc,,,r * a-C - +D -.Bratf Pri�{�/ << r) <br /> - <br /> c4 {e5 iv be 3o P-f <br /> ®N otaA ,b 9 <br /> r �� s Fee Rec: 5-0 <br /> 40 <br /> c Check#: 6 ST <br /> m <br /> z <br /> z <br /> y •- a <br /> Date of staff site visit: 3/7/2-3 Initials f site vi 't staff: <br /> Hi <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: 3/131)3 i -111 <br /> �'� <br /> A CO ter" <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 71 N <br /> r. 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 e,-, co 0 <br /> Burnett County,WI Land Use Application—Rev 12/2022 <br /> K <br />