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• <br /> LAND USE PERMIT APPLICATION —Burnett County, WI e <br /> r 1 <br /> ca <br /> Applicant Complete All Sections Below This Line °' CD w <br /> CD. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 o <br /> rs <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 t <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °, <br /> IJ\ Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 ; ).10 • <br /> Filling/Grading $150 Boathouse $500 <br /> C/i pip <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> ;v <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. '� <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. r 0 p <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ..-•k z ,k 7 o <br /> Property Owner's Name: - i M M . '��� '/ru S�- �►®yrl�tS 4��'1ct .chPz') 8 <br /> p / ','. 1 <br /> Property Owner's Mailing Address: ek l kVe6+ f L� %t i k, hin). S j 7 ---k <br /> � yy�� � City State Zip i <br /> Property Site Address: 3©1g1 L/�,A6 .hri✓Q.r/ l.a'. v'i bi,D 1,0x• fit, o y 'mot <br /> Contact's Telephone Number: q52-21 Q- 7cc 9 Q 2' t <br /> ,�" f o <br /> Contact's Email: -f5h&Q, iLD &+Vv zl (•Cvrn g <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N .-o <br /> legible and your email provider will accept emails from the following addresses:@BumettCounty.org and o. <br /> � <br /> @BumettCountyWl.gov ° <br /> Legal Description of Property: Min✓e OCUA. .0 fl airk L:\eir_S )IAuf WT 10 a 0 Ui"ID1--7.4- 1`it' '. <br /> Section#: oZ 7 Town#: �1 N Range#: I 5 W Town of: 51j.)15S I n+. i r Ol ckl0f <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 55 (I <br /> Tax ID#(1-5 digit number;found on tax statement): ) 1753 IN ' <br /> 30x5a Cevy,e.t,L-t- Slab iv, -f vrnn.-t, j 3 (&-4...., - C ` 4�.3 <br /> Proposed Use of Structure/Addition: vi vex., vet,Ice t)u/C t.uwl .3 5 is t2 a 3L e1 .ti,r, 1 a/rvs C <br /> Anticipated Start Date: ha i aiLti Vi . (Home/Cabin,,Commercial Businds;Bedroom;Deck,,etc.) fek.+ a.ctro�.�ti rz, <br /> for -Are fif; <br /> Building Contractor: Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Qf'1ee - all se 4.cits u\ <br /> s Fee Rec: <br /> ►.2, <br /> Le. Check#:J I?35" <br /> m <br /> a <br /> z <br /> �/15123 5. INS tr,y � am`-_! <br /> Date of staff site visit: Initia +of site sit staff: < v r <br /> cf., <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 9/t7o/2.3 CA co cn a < c , <br /> CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z y n <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 <br /> Page l of 5 < C <br /> Burnett County,WI Land Use Application—Rev 5/2023 0 L....... <br /> -I <br /> a <br />