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LAND USE PERMIT APPLICATION — Burnett County, WI a -0 <br /> a b <br /> Applicant Complete All Sections Below This Line o c .p <br /> Permit Types and Feese/ease,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 _OQ 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .-4 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 N. <br /> G <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ., N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 —A <br /> r0' �% <br /> Filling/Grading $150 Boathouse $500 <br /> CO F , <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 /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> z <br /> Property Owner's Name: .�U f J S ete-rs o o (' <br /> p oa. (� <br /> Property Owner's Mailing Address: 78-5-� C,.O t ��- FE ( k is+'r �1- S-y am w n00 <br /> City State Zip VI <br /> Property Site Address:7 5 Cry kJ • F-1— 4 _e&.s WZ S'Y l <br /> o <br /> • r, <br /> Contact's Telephone Number: 713 " 5 ,Ic - /U Id a <br /> d <br /> Contact's Email: /re.P_..*" 7.5.— w jail. <br /> ako a , co 4, FD <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: @BurnettCountyWl.gov o °O <br /> rpz <br /> Legal Description of Property: / ,T / C-St v' / 'y p � ds. P <br /> Section#: Town#: ?j 7 N Range#: / 6 W Town of: e,C44 O Gil 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* CA <br /> o � <br /> Tax ID#(1-5 digit number; found on tax statement): 1 1 z 9 7 2 <br /> Proposed Use of Structure/Addition: Pete S 42,c( <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> z J <br /> Building Contractor: Sewer Installer: 7 5 <br /> tn <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: c <br /> . <br /> 0 Mkt* Ca SeA1Oaa-S <br /> m <br /> (?). N04- ko I� U�ec. foe' tqu fn.a41 \RLAiokth , <br /> �s—� ee <br /> Fee Rec: I <br /> ( Strt1C— - <br /> °z Check#: <br /> AA_ I,id.s -b be, .:cc d. a lo a d c, <br /> ck 14u1n bye 3Di <br /> &Cfgfu-k- (lid -itip skd be pefini44..i or rtitoovL bti Perm+ -aPi ati-i3 2 L--' <br /> e r <br /> �i/ DI $113/015 M v <br /> Date of staff site visit: b ! f�Z� Initials of site visit staff: �L 1 [' > (,W C 0 <br /> APPROVED BY LAND SERVICES OFFICIA DATE: 3/Z,DZE m : irifii <br /> o <br /> C o O° <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF c4 <br /> 11111 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> J <br /> Page 1of5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />