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LAND USE PERMIT APPLICATION —Burnett County, WI a I <br /> .70 <br /> Applicant Complete All Sections Below This Line a'. p <br /> Permit Types and FeestPlease,check appropriate boxes) a. <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .. 6- <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .i) <br /> ^ O <br /> °�E Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <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) $100 2. <br /> _ <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. n _ <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> ro V, <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' I R._ <br /> z <br /> Property Owner's Name: r4 l" ) 1 act <br /> 8 0 <br /> Property Owner's Mailing Address: � U-�` n <br /> Cit State Zip cn <br /> Property Site Address: V ‘ VO‘ 0 o N <br /> Contact's Telephone Number:—1\ S - ji - TDA 01 "� a. <br /> Contact's Email:Sc 10 r ?fa, P pouLs <br /> I• cop() �%**If staff has a question about this application,you will be ed via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0 °Q <br /> S. <br /> Legal Description of Property: E//s Sk74-/ NW fit.j d <br /> c <br /> Section#: 3 Town#: if/ N Range#: /S t W Town of: S v+'sl o" <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> o <br /> Tax ID#(1-5 digit number;found on tax statement): 2 114 Q' 9p <br /> I <br /> Proposed Use of Structure/Addition: 4s ic.7L '- <br /> Anticipated Start Date: f/to 244 2 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Building Contractor: Sewer Installer: y Z z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY mVC <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z °Q <br /> -�v' 7 A A9/1 ° <br /> t) l�o� �� u 5 u u�a v► orn C <br /> sf N G� l r er PI�e�s 7v 4 e a7L lers7L /D Pe�� , � "�ZS /y � �y/� FeeRec: �, <br /> e_ yioe 1161e OP Hit's Pcirr-J ( <br /> 0-00( ' I/ 21/6$ 4- 21 I Co t{ z Check#: �-77�F n , ean. /1 e- O Pa S /d <br /> flee.° 74., be, c,0/...1 L/iIe2 0oi/A a Cer74-6'aci ury //At t <br /> Date of staff site visit: 9/6/ZOZ t Initials of site visit staff: / '/' a 03 <br /> n MI <br /> m c n <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 979/Z4 z y `-•g v (/ <br /> 11 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF o. N o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT g nC <br /> I ' �ri11 <br /> Page l of 5 J <br /> Burnett County, WI Land Use Application-Rev 04/2024 <br />