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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> it <br /> Applicant Complete All Sections Below This Line c 6" <br /> Permit Types and Fees:(Please,check appropriate boxes), d <br /> Dwelling/Principal Structure ,$300 Addition/Alteration to Dwelling/Principal Structure $200 v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 -...Z .....40 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 (S IL) CD <br /> g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 (� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)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) $100 0 , <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. & , <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. fD 1 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o P <br /> ,11 , .\ o <br /> Property Owner's Name: 1 4 \L r 6-ti t—'o o W <br /> Property Owner's Mailing Address: <br /> a8` 6 I4 Arze,_ S 7 tt)l Ea. <br /> � � [��"Y'`� � City State Zip o v <br /> Property Site Address:/-•e 141 (k a g !}"` i'day bor `''y g 3 o < t 1\ <br /> o h <br /> • <br /> Contact's Telephone Number: C¢ ( q c> g -a- 7 S 7 �� a `t <br /> d r <br /> Contact's Email: () he k) 50'/�' m A-i( , e0 <br /> CD <br /> **If staff has a question about this afplication,you will el contacted via email. Make sure your email address is -o r <br /> legible and your email provider will accept emails from the <br /> l/following address:J� @BurnettCountyWl.gov` / °O <br /> Legal Description of Property: L©T i L t At 4z ex-t/� ew -+�D i ri 0`r t��' y/}y V /i 14-,+r'-- . <br /> 3. <br /> Section#: -7 Town#: z0 N Range#: 01 W Town of: 5at7-ri <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* En <br /> 1 0 <br /> Tax ID#(1-5 digit number; found on tax statement): / 9 t 0 b v i d <br /> Proposed Use of Structure/ ition: r�`--(N-RPsg t — 12. X 9 - <br /> Anticipated Start Date: .9 . . (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> s aa' 7.70 <br /> Building Contractor: Pc-V"$j It,) L L . Sewer Installer: y Q <br /> W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS/LISTED BELOW: <br /> 0 We7 T, Ie N S d 1Cr A a a,A all 4 a,r'i,7"/4 4o,,t. E <br /> F, <br /> m <br /> a� (� —c <br /> - Fee Rec: <br /> °z Check#: ale (0 <br /> r <br /> •< <br /> Date of staff site visit: 0...,/,,,, Initials of site visit staff: / 'iZi rrl <br /> < P <br /> APPROVED BY LAND SERVICES OFFICIAL: 4 : / Z. cA <br /> 3 n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 5 73 <br /> 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 0 n <br /> Page 1 of 5Ind <br /> Burnett County, WI Land Use Application—Rev 12/2023 = (..` ) <br />