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c. -0 r <br /> LAND USE PERMIT APPLICATION— Burnett County, WI . <br /> E. 7 tJ <br /> Applicant Complete All Sections Below This Line o a �' <br /> Permit Types and FeesiPlease,check appropriate boxes) d <br /> xDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 NAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 A <br /> 2$250 o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse Gri <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> h <br /> $500 <br /> Filling/Grading $150 Boathouse v7 <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. „d <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. r 5 1 . <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ° <br /> 0 <br /> =' N <br /> Property Owner's Name: P iaii ptry II f q 2 o <br /> a. <br /> Property Owner's Mailing Address:)g i�-y CfA1; M � VkJ ); ,/L "" 5 13 1 <br /> , A �- Q City State Zip c' <br /> Property Site Address:2(DSZ 1 i V) 1 I p �; n 4 ► CZ _e Q.c. y\kiL I v s o I o <br /> 1.2 <br /> Contact's Telephone Number: 76. A d-100 a. <br /> co <br /> Contact's Email: y'ACA C ���� 9'D r` 4) �q i 'c im 1 <br /> **If staff has a question about his application,yo ill be contacted via email. Make sure your email address is o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.go` c. <br /> Legal Description of Property: _ Su I i 0 • <br /> -eCO • 'r. ckS C . g. o <br /> C�o� N <br /> Section#: Town#: 7j q N Range#: W Town of: �u �'73�� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system • :•• , ••! `n <br /> -3 <br /> )T <br /> ax ID#(1-5 digit number;found on tax statement : 369yy 70 a _ ox <br /> Proposed Use of Structure/Addition: v Oki - <br /> Anticipated Start Date: IX S ci,. (Home/Cabin;Commercial Business;Bedroom;Deck:etc. tAl <br /> ) <br /> 1n �l t �� (�S h j %p 7d G <br /> lSewer Installer: Vv�lk'e U& 6 I tn tn so <br /> Building Contractor: b mP V h P <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY rn z - <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: xi <br /> Q MEET RLL S i 4cks m <br /> < l: <br /> O 'wets_/AA= A..01 it cGtec 4 eeP oOwtS we 3Ak;- ,231.. -6 <br /> y <br /> H <br /> a , <br /> Fee Rec: ,3 -® <br /> 0Je <br /> 0, Check#:(011K9 <br /> r- —1V1 <br /> Date of staff site visit: \\\1- Initials of site visit staff: ) m FDI <br /> APPROVED BY LAND SERVICES OFFICIAL: - % DATE: if /3/2n 25 ' <br /> ,:..i• ' <br /> e 01 <br /> UPON APPROVAL: APPL ANT MUST POST COPY OF o I <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ! L.„i-7 1 m <br /> Page 1 of 5 I` __ <br /> Burnett County,WI Land Use Application—Rev 11/2024 ��-L--.._..___ ------ <br />