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LAND USE PERMIT APPLICATION—Burnett County, WI h <br /> Applicant Complete All Sections Below This Line w <br /> CD I <br /> Permit Types and Fees'Please,check appropriate boxes, —, <br /> Dwelling/Principal Structure 0300 Addition/Alteration to Dwelling/Principal Structure $200 .. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 � . o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 � <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 +lJ Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350EL' Q <br /> Filling/Grading $150 Boathouse $500 ' 1 <br /> D. rs <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 0 <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 Cik <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ^. <br /> I <br /> Property Owner's Name: t y A CIej ►r/�h l�,' ✓ �Y1V1 l�'lG�r�!/r I 1 di k- o — <br /> Property Owner's Mailing Address:�yD LO it c��e �1 D M,„ `p�i' s M `'�4 6 n W <br /> , ` ✓// ' f City State Zip ° c <br /> Property Site Address: .7 1�Q N . �U I r'1 1 (_Gi l4 i+ j j( la S{-tip o N <br /> Contact's Telephone Number: <br /> (P I Z. Z O 7 - $8 7 y a. <br /> c �. <br /> Contact's Email: ill 1G16 Y L l Ac >r C))`ytGt 1' , 0-L Y1-r " le <br /> **If staff has a question alfout this application,ytlu will be contacted via email. Make sure your email address is N ro ts <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and 1 (10 ) <br /> @BurnettCountyWl.gov <br /> Legal Description of Property:LC f- 1 C 5i S 1 1) 111, ( I � IQ l)k 4 lCv f- ( U-}-- I) '' S r <br /> Section#: 7 Town#: / N Range#: I C W Town of: �i a c I L So v ���' cn , ^ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 3 ' ' <br /> Tax ID#(1-5 digit number;found on tax statement): �7 1 7 7-� e) <br /> Proposed Use of Structure/.dd'tion: ±.�kl '` y �,\ ON <br /> Anticipated Start Date: 1/s- 2 3 (Home/Cabin Commercial Business;B�e`droom;Deck;etc.) <br /> Building Contractor: vl(ofth fh-j vi.S 1 14.)' Sewer Installer: a 1- 1,--t1f((4 ' . C <br /> z ! N\I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TOrALL CONDITIONS LISTED BELOW: _ <br /> •a1 4Y Yfl 4l( �4c15 (30'6 � 9.D,V) Cal <br /> 0 9)well2' ►mil 4 exc 3 ,ropoi5 aec 5'4N- a 3-) <br /> 05;14- 'T?ice 70 be �et��1/T��' li 1-,, I w. 15 Fee Rec: t3464 <br /> 4 Check#: a .3 <br /> ll --- <br /> Date of staff site visit:VP-03 q/,�l?3l Initi s of site isit staff: r1 pd <br /> < `� <br /> Iolsia3� io�6� -' <br /> APPROVED BY LAND SERVICES OFFICIAL: /� DATE: a3 a r r <br /> y (D ea I""+'3 t <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o N aa CD 7 <br /> ao -- <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 Natl.' <br /> C, <br /> Page 1 of 5 il` <br /> Burnett County,WI Land Use Application—Rev 5/2023 d 1 '------ <br /> ro <br />