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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a " <br /> . <br /> Applicant Complete All Sections Below This Line 0' c' <br /> PP P a , <br /> Permit Types and FeestPlease,check appropriate boxes) +/' <br /> Dwelling/Principal Structure $300 ,X Addition/Alteration to Dwelling/Principal Structure Aip. a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure .0 ti3 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1Accessory Structure(Commercial/Industrial) $200 _Addition/Alteration to Bunkhouse $150II <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 01 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0k <br /> Filling/Grading $150, Boathouse $500 r <br /> Solar Panels(Stand alone or roof mounted) •$150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. iS w <br /> z <br /> Property Owner's Name: las I e Il e A_ p,, ice. ., .11 <br /> o - > <br /> Property Owner's Mailing Address: 6{(l42cj i .ee f 'l Tr bury cal- 7.3O �' <br /> Cityy/' State Zip <br /> Property Site Address: a�i (� 7� g C2 o <br /> CD <br /> Contact's Telephone Number: 7 f S— 6 3( —77 3$ a <br /> C7 <br /> Contact's Email: d.c,e_kk S C J 6A02.1 ( t £owl a <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is .0 ,— <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 5 °Q N <br /> Legal Description of Property:bEP04 Ki--Dl7 -TD VO`( C-R V ILL 16t LOT 13 3 t. <br /> Section#: 1 d Town#: y D N Range#: 15 W Town of: J 4 Lk- e1() 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* (4 <br /> Tax ID#(1-5 digit number; found on tax statement): tY YZ5 <br /> / 0 g <br /> d <br /> Proposed Use of Structure/Addition: f SEAS on/ 2 fin^ 1 &F_C k coR. C,'/Q/t(._ ,-3 C� <br /> Anticipated Start Date: As A-p (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> fv <br /> Building Contractor: r�CELLEn) e c I 0 E,25 Gut c.DF Sewer Installer: y O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> CIZtv ie. cow+t/H� 01)11 4 Ai to OAA U <br /> yri <br /> C'Dw-e,u l no-I- -1-0 f e 3 b 'aoms S -ELI-L. I Fee Rec: 1200.� <br /> cDCDN-Lith �,� t-c-o r n Vt d ' CAc (LU ) (nS '}01/ - n j NtL.esiary z Check#:�/CS G` <br /> rn <br /> rn <br /> << <br /> Date of staff site visit: R/I,1 Z% Ini 'als of site v' 't staff: r <br /> q �n MI <br /> APPROVED BY LAND SERVICES OFFICI DATE: / 2// y so rCda n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o oCrl <br /> JJ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Pagelof5 = fnl <br /> Burnett County, WI Land Use Application-Rev 04/2024 LL JJ <br />