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LAND USE PERMIT APPLICATION— Burnett County, WI r <br /> Applicant Complete All Sections Below This Line �' P <br /> Permit Types and Fees'Please,check appropriate boxes) a ° p` <br /> fF <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 co <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <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 E <br /> Filling/Grading $150 Boathouse $500 r <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 r. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. 4 <br /> •-o <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. p <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g »' <br /> o 1 <br /> Property Owner's Name: Gene 4— rt rt, y it%Abe, Q N , <br /> E. i <br /> Property Owner's Mailing Address: - l$ i (}o/1t(, Ln N Ssw. ? - <br /> " City State Zip n k <br /> Property Site Address: a vo qC q p 0J, let tow R1'i er RA_ hiQ. itt- 1 Lul ..4-ci?M 1 C y <br /> co <br /> Contact's Telephone Number: \j o <br /> p iiJJ `�5�- �3U�C� , <br /> Contact's Email: 3rtf k 1 a L b ( Li Cl 1 r «m <br /> CD <br /> **If staff has a que on about this application,you will be contacted via email. Make sure your email address is N re <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov 5• °0 b <br /> uo <br /> Legal Description of Property:Rl'\f ex"Oaaj 1.C+ 14 IA—lint 11' Ot.t ls;'1-5 i el, a... 9. �1 <br /> Section#:. O1 Town#:Ti C N Range#: R t U. W Town of: C Kit WM <I' N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7C1ba, <br /> W C7' ° P <br /> Tax ID#(1-5 digit number;found on tax statement): ,I t 1-. 4-q J a — <br /> Proposed Use of Structure/Addition: C' ( b n._ QL)Ze_be. -� <br /> Anticipated Start Date: ,Ar i j IS r a0a9 ` J(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> g <br /> Building Contractor: 30 f Sewer Installer: n I C(, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 6 <br /> M eef au 3-e+baukS <br /> ( 1\;ti+ <br /> ri <br /> lied -f�c h � i °'�' r <br /> I I _ C � Fee Rec: f`) <br /> lJ �l�`i Y �11�� YX rC.Y1'l�V C✓ Cb no P.C� S S�S 2 Chec 1C77 71‘•I 1 11 ► ►2u2N ca <br /> n <br /> /� 1 2 <br /> V Date of staff site visit: ilIO )7--4 Initials of site visit staff: i (�— tv <br /> APPROVED BY LAND SERVICES OFFICIA . DATE: 1 sq/zbZ`1 ii r— � <br /> b 3 L u <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o o <br /> Page 1 of 5 °K N.' <br /> Burnett County,WI Land Use Application—Rev 12/2023 CD <br /> I ITT <br />