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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> N' v. N <br /> Applicant Complete All Sections Below This Line a <br /> Permit Types and Fees'Please,check appropriate boxes) p ... <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ;; <br /> Commercial/Industrial Structure $300 ,Addition/Alteration to Commercial/Industrial Structure $200 ^\7D p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 7, <br /> I <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c �` <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> <. <br /> r- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 (E <br /> F,• <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. r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ^ <br /> -71 <br /> Property Owner's Name: I C Ln)s," (- A.iJ`it ' -_ °o <br /> Property Owner's Mailing Address: 4 1 0';-,„,,,''.) , t'r_' <br /> �,, City State Zip E <br /> 8° <br /> Property Site Address: \�` ���- ° v, <br /> Contact's Telephone Number: ) / c (C ) "3 0 3-0 <br /> o <br /> Contact's Email: r cA s V?..{ry 1 S vr e t4``J1,-) CS i S W 1 U . U,) ' * 5 (`f <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is o ao <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWl.gov a. <br /> Legal Description of Property: O)—' 03 R - ` ut ( _ f(__ 'c: - ( O� ckO�(OOG1 . 0 <br /> Section#: - : Town#: Lt t, N Range#: I V W Town of: '�`�;t ; r'ir3.*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* To <br /> tr' <br /> Z2C) % 0 N a r,Tax ID#(1-5 digit number;found on tax statement): p <br /> Proposed Use of Structure/Addition: '1>Ar1`:V-4 4 t ) C 0 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom.Deck;etc.) • 1J <br /> Building Contractor: {��d\ J lf�t k S 1.Z Sewer Installer: y 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY g z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i Z <br /> d 'Vim+ ryu,E loC4 w-t aci 4Dn^ a,(.1 19(o lutes g <br /> m tt <br /> ., <br /> • Fee Rec: /V/ R <br /> i' Check#: <br /> r <br /> •e <br /> A <br /> m <br /> -vv.� 4 <br /> Date of staff site visit: !DI Li 1202L1 Initials of site visits ff>�/� �J <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE:/V 6J/20Z% 1 <br /> CD a <br /> UPON AP <br /> PROVAL: APPLICANT MU T POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTCD C NJ cc <br /> Page 1of5 l 2. ,____.____.. ),1 <br /> -i <br /> Burnett County, WI Land Use Application-Rev 04/2024 1 <br />