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LAND USE PERMIT APPLICATION —Burnett County, WI <br /> Applicant Complete All Sections Below This Line a• <br /> Perm' ypes and Fees(Please,check appropriate boxes) <br /> v <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> mmercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 '� O <br /> ....veicA) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C. <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> o , <br /> Filling/Grading $150 Boathouse $500 '- <br /> a <br /> Solar Panels(Stand alone or roof mounted) , $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> y <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `$' <br /> -c If <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. <br /> z <br /> � � �L��, - Q C <br /> Property Owner's Name: ek,\I to r I.i'C ti Dtx e l_ �Y"Qvil f 7 N <br /> r /_ �A \ C0. <br /> Property Owner's Mailing Address: 3 i'I(oI Me� 1 rt I , ,�� � 546 3� . 1 <br /> ,Q_ City State Zip <br /> Property Site Address: 7{)It 4, ilor3 1 9 35 M[.,V..ft --r✓ I < — <br /> Contact's Telephone Number: -4 J"' (—( lTh CK -� --1 3(4 2' • <br /> c.") e 4 <br /> Contact's Email:' y-tukc,i2'Q cili' •Ct' \' i <br /> **If staff has a question about this applqation,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept mails from the following address: @BurnettCountyWl.gov <br /> Legal Description of Property: fi. N€ 4I4- 1 ) 14 <br /> Section#: .S Town#: Li I N Range#: 15 W Town of: SWISS �' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ,, <br /> H H <br /> Tax ID#(1-5 digit number;found on tax statement): S(D C.I Co 0 W CD x <br /> 3 d <br /> Proposed Use of Structure/Addition:��y H W <br /> Anticipated Start Date:3 f02. i (Home/Cahin;Commercial Business;Bedroom;Deck;etc.) z .4. ' C <br /> ,� �•c <br /> Building Contractor: (; L�'�C�► Sewer Installer: C D ltz c <br /> ter <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a <br /> m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> ti <br /> 0 MR t+ & -GUu SeloS 0 <br /> 7-5 <br /> C)1%1- -b toe Use d -C-of lnuynar lAr,L6A-tu.4- 1/\ �'� <br /> ( jam �" �p ,, Fee Rec: <br /> � 1 V1 VQ,(1 Y�t�- 1 S -6� Ol 3D x 5�1 co S Yl.e d • 1 lcui s .. al r Check#:_� <br /> 6ASk iin -- Wr lets. x <br /> ^C":2-J <br /> Date of staff site visit: I'/1'20ZL4 Init'als of site v' it staff: U t!11 <br /> G� /ZOZL/ <br /> APPROVED BY LAND SERVICES OFFICIAL4' DATE: l//3 g.� G 0 <br /> m - ^s InrL <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF j N <br /> °� l. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT co UYO! <br /> -4.- <br /> Page 1 of 5 <br /> � <br /> Burnett County,WI Land Use Application— Rev 04/2024 i <br />