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. LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line c 44. <br /> Permit Types and Fees(Please,check appropriate boxes) \ a� �f�`` <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1J Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..� <br /> \o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 Pp <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 tc '. <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 k ill <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping, etc. a <br /> z <br /> Property Owner's Name: - f t 'r^ / s F. <br /> Property Owner's Mailing Address: 0 91 3 " 611'U 3 5//'e y' 1' 9-l1 T %a'. <br /> �j p/' v _1_ - ,- City State Zip <br /> Property Site Address: D l ((i CI-CZ_ G I`t I 1 11(611.1.CJ� -Guu.. <br /> ts. N <br /> C <br /> Contact's Telephone Number: 7/C 3 e/'- 3 01 rp <br /> N a <br /> Contact's Email: <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: <br /> @BurnettCountyWl.gov °0 <br /> � <br /> Legal Description of Property: 7 2 GSA Vo/ Z " '/ , zg-e( d N <br /> Section#: 3 I Town#: 3 N Range#: If. W Town of: hrx e,(--4-,U n <br /> (;)- _-'V <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c <br /> Tax ID#(1-5 digit number; found on tax statement): 5( 415 D ) W ° <br /> Proposed Use of Structure/Addition: BUR.. 31(1 - <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: yz <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z z <br /> � 1 S <br /> I N67L 4 Le ZlS� �{^ 4UtitaN t 4 h/'Aa {1;t?. <br /> 9 <br /> m <br /> w <br /> y <br /> Fee Rec: <br /> )5D4) <br /> ° Check#:t�(2)z <br /> r <br /> -C <br /> r <br /> a) <br /> Q <br /> Date of staff site visit: .. 7qq/ Z V Initials of site visit staff: }-'2, T m�° <br /> 11 I <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: S / 20 Z CD <br /> ram' <br /> U <br /> o 0, <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Erfil <br /> Pagelof5 L��J <br /> Burnett County,WI Land Use Application—Rev 04/2024 <br />