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, <br /> 4. s <br /> • <br /> finaij AP p/Zn v P <br /> LAND USE PERMIT APPLICATION-Burnett County,WI a. r" <br /> Applicant Complete All Sections Below This Line °- <br /> Permit Types and Fees'P►ease,check appropriate boxes) Oa. <br /> 1,1 <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 J) <br /> V Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <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 k k <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 /> r. <br /> *items not listed obese will be treated as accessory structures,such as:pergolas,landscaping,etc. ° <br /> Property Owner's Name: R i c h C,r d a- C LA M en i r1`')S _ =-' Cs) II <br /> �jl.d c-1 W LCaktvill� MR1 SStiLi g �, • <br /> • <br /> Property Owner's Mailing Address: `{1 g- U • <br /> City State Zip 4 <br /> Property Site Address: `0ri3k. Ili ki\t.0Ot. ©r t Lai S fte of WI%141.•., ?thy, ,.,,' SPrr+F n <br /> lri•.4n3( '•c:aeLou LLke • = s. <br /> Contact's Telephone Number: —I L 5 -1 S% -.-LA 10 a <br /> P <br /> W <br /> Contact's Email: r LN rh c'•11•i- Q C.;.,in c•t 1. CO M <br /> **If staff has a question about this application_you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address:I�.BurnettCountyWLgov �. nr <br /> rio <br /> Legal Description of Property: L 0-t' 5 P r 41 oc vih IS Qc c;l%ei Fief cif c p tr i i LA tct g <br /> 1. <br /> Section#: /2 Town#: 37 <br /> N Range#: 13 W Town of:"Tracle L( <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c4 <br /> Tax ID (1-5 digit number,found on tat statement): 33 3 0 5 r' <br /> Proposed Use of Structure Additi on: S 4 or v rt Ca e c.1 v.. L i:in r.i,,h:;c N ca r-) -1 e <br /> Anticipated Start Date: *4-by - LN (Home/Cabin:Commercial Business:Bedroom:Deck:etc.) -1 <br /> Building Contractor:O i1.. tiA 'UN;Ai oc 4 to r Sewer Installer: G <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 6 z U1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 6 ' <br /> 011 ,+ 0 se.4-oay.,k-S <br /> in I <br /> 0 r llM 40-Y7 /Pe/ 4 -eO iu - ma Fee /5D92 <br /> D/Shf_..cl pve..r \Dst4f needs a Land te kiimi+ by 1I1L2D2L Check#: c131J'_ <br /> rjlte-kiC' -fink lirits -w b. seLLLWi ! a lock old c149-1n by ibizDzy RI <br /> RI <br /> U ��,Q › ' J <br /> Date of staff site visit: ` /3 0� Z 1 Initials of site visit staff: G 4- i-r , . %l <br /> APPROVED BY LAND SERVICES OFFICIA DATE:5)7/c Q 424 D <br /> 3 i� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <.m3a 0 <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 o cc <br /> Pagelof5 w,.< <br /> Burnett County,WI Land Use Application—Rev 04/2024Inn <br /> L� -J <br />