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LAND USE PERMIT APPLICATION—Burnett County, WI a R <br /> til Applicant Complete All Sections Below This Line g ''I 4. <br /> Permit Types and Fees fP/ease,check appropriate boxes) e <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 w ii *A5' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 , V <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. i I to. <br /> Z <br /> a <br /> Property Owner's Name: CV r 1S-I o FA er 6 aw.i e-r-tt 5- J e,- Tr45-r 6- 'SAcv ;. <br /> tv <br /> Property Owner's Mailing Address: 9 -1 3 ,,..A.be,--\,"�e bra: ( 041 S lle'Sk"s 14JJ 6�a7 . n Es <br /> City State Zip E r' <br /> Property Site Address: a C 7c7 West- L2psr-t-- Lakre Fearr� o — <br /> • <br /> lik <br /> Contact's Telephone Number: �D5 I- a(°)--7 4 60 a. <br /> Contact's Email: h-a3--1'4 e-r-Fe.5 y Aee-L> y e-.1,16 d . Cu <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b ;. <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov Q4 <br /> Legal Description of Property: <br /> See ct-f-.t-c..c e40 P. 'k\ <br /> Section#: I3 Town#: 37 N Range#: I LI W Town of:�S IC 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> I SR 1 ° <br /> Tax ID#(1-5 digit number;found on tax statement): \ w <br /> r <br /> Proposed Use of Structure/Addition: E'`�©. e i.:1/4.c'r-,,,,,. o c (La,: 4-.. c,--e...,,e secs e LA pe$,C1-1. .� <br /> Anticipated Start Date: 0°t 1 a v a ti (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 1 <br /> Building Contractor:T)cS o'- \IRA1e5'To,.e e 1 ..,,'S Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0 z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: › <br /> 'U Meg+ U,u St,-+AJcS - <br /> (�Con�tu,� U�ni-C�rv� I,we-u:tI`q Code ( c lnS e�-fir for and 11eceSsu ry Re-r <br /> rni+S -t= <br /> D'S*4-kC -kknk lid 40 be Seu),A-Cd 141-k a lock 0'0 c-14- - 11/ i l�zczil d <br /> See <br /> l', LL ���nn�� 1'11�A!! q/� �,1� a Fee Rec: ck7- <br /> 4 See a-W-a� Fib+ ow ,t( 54,Adure" 1�1<l Joo SLr� V IW� ed htet4 2 Check#:to/7S <br /> OP s2 -bcic S_ �` <br /> F <br /> Date of staff site visit: 7/ J J2q Ini ials of site visit staff?( d —''&II'nn���,,,, <br /> 3 bird <br /> APPROVED BY LAND SERVICES OFFICIAL: dial <br /> ? DATE: 7IZ1//2J <br /> f ; (DW 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N <br /> 00 CC __ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT < <br /> CD <br /> CD inn.I <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 12/2023 J <br />