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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> • Applicant Complete All Sections Below This Line <br /> Permit Types and FeestPlease,check appropriate boxes) a U.) <br /> 1-3 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Q/ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200U.\ O <br /> 1 Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ,•-.. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ti <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °e <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ♦ <br /> Filling/Grading $150 Boathouse $500 •, ' <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. `5 <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. �ro p I\ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Fi <br /> z <br /> / <br /> Property Owner's Name: C t:.C S'-Ze-t(e P14 e;( c IV <br /> .0 <br /> Property Owner's Mailing Address: ((8(25 ate Lt1 redden L 13t :37 E. n <br /> City State Zip v) W <br /> Property Site Address: �d4 ,/ o <br /> Contact's Telephone Number: 1{35—�'`10�7 l a-7&f `�''3S- 3"�a'Z`f" Cl. <br /> Contact's Email: ccy Z eice pLe`to s Co' ('cc..ke.t1'Hc4.,%• C.15-rr- C' <br /> **If staff has a question about tliis application,you will be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0 °O i <br /> 0. <br /> Legal Description of Property: N 2D S E CFO <br /> #: g.I Town#: 37 N Range#: I W Town of: Trade, ke <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c4 <br /> H H <br /> Tax ID#(1-5 digit number; found on tax statement): c Z? 3 I'7 W o <br /> Proposed Use of Structure/Addition: a20 X 410 5k c c .\ H <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> z W <br /> Building Contractor: - a S, E'-r. 5 Sewer Installer: 1'-EZ-y"� J ,� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o x <br /> y <br /> ID 11/1-Qt+ AP Se-1100,4S rn <br /> r <br /> VDD .� cxV � VC ' Sy Oat/ y <br /> Fee Rec:13]' <br /> ° Check#:g 213 <br /> r <br /> -G <br /> m <br /> < r inn <br /> Date of staff site visit: 5I ZZI20Zy Initials of site visit staff: T + lam! > g)g <br /> APPROVED BY LAND SERVICES OFFICIAL.14aQ1 DATE: 5J3/ 2y 1.-4 inn <br /> t <br /> w <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF $ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3hi <br /> Page l of 5 <br /> Burnett County, WI Land Use Application-Rev 04/2024 <br />