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LAND USE PERMIT APPLICATION -Burnett County, WI a <br /> b <br /> Applicant Complete All Sections Below This Line "�� w <br /> Permit Types and Fees(Please,check appropriate boxes) e a W <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 e�0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 M <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 , d <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 9 ow <br /> Filling/Grading $150 Boathouse $500 w <br /> ;n 1 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ? <br /> ii <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. <br /> r 1 <br /> z <br /> - <br /> Property Owner's Name: P.j�ard a l&!I ee. N f'SSeIi " <br /> s p I► <br /> - _/ —O <br /> Property Owner's Mailing Address: 93 ZS— �v�c�v Dr,ye/ L4Jd S ' il, MN Ssi _ <br /> Z�4 � City State Zip W <br /> Property Site Address: 1 bole L*V( t Wr 5'[�S3 0 — N <br /> Contact's Telephone Number: (5t 3) 346—7136 N a <br /> Contact's Email: r rAI5. A 3` Imo <br /> **If staff has a question about this application,you will be contacte is email. Make sure your email address is N -o <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and °Q <br /> @BurnettCountyWl.gov U. W sl <br /> Legal Description of Property: Lat(c CSIM 5% vOL14- P 30Z 3. <br /> Section#:Sa-1 Town#:T3714 N Range#: PAW W Town of: T lyl. % v) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* N IV ? x <br /> • <br /> Tax ID#(1-5 digit number;found on tax statement): 35009 <br /> � ° <br /> Proposed Use of Structure/Addition:e • r. ' Vi t i 1 y; J Q <br /> Anticipated Start Date: V*M.e . 45, (Home/Cabin:Commercial Business;Bedroom;Deck:etc.) <br /> Building Contractor: Sewer Installer: Nf.4 <br /> z r-.. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> - Dl ett all st+ba S <br /> �n <br /> -No+ lnwm an ��bl-�+` la r��� �Xceecl ►�j,N Fee Rec: /�QCO <br /> -All 'i m{�em-0,t S r c e no-kJ I n -1-�.e fit o ff- n Ga d Check#: q <br /> cn <br /> ri <br /> Date of staff site visit:(0/L /Z3 Initials of site visit staff x <br /> 2 n <br /> APPROVED BY LAND SERVICES OFFICIA . DATE:6 A t ZDZ3 _ J J <br /> > ��_ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF - _ (MJ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT > 0 <br /> Page l of 5 < N = ^' HI <br /> Burnett County,WI Land Use Application-Rev 5/2023 0 o 0 o <br /> CDw 1%..) <br /> 3 to <br /> m 111111 <br /> L J <br />