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' LAND USE PERMIT APPLICATION- Burnett County,WI a <br /> Applicant Complete All Sections Below This Line = 8 A <br /> Permit Types and Fees:iPlease,check appropriate boxes),; + G <br /> 'k <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> _ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk ,Bunkhouse $250 <br /> 110 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 s' ;11, <br /> , <br /> Filling/Grading $150 Boathouse $500 ►‘ <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> °N <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. S it <br /> z <br /> 0 <br /> Property Owner's Name: of et °CIS Q <br /> C'�% U. i,� I <br /> Property Owner's Mailing Address: OS C1�1 tiC� l�viicCfC�CJ �(- 663y n <br /> 22 _(� City 1 State Zip � <br /> Property Site Address:�c�c' c�n ��Q �U St�;'e' n 'Pt <br /> 1 (.t�,S o <br /> Contact's Telephone Number: \ "C,(61 —L1 g-oS <br /> �, c <br /> Contact's Email: ! 1 S G Ct O d e e lw 4 c o o. co M co <br /> **If staff has a question abut 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: @BurnettCountyWl.gov W <br /> A. r <br /> Legal Description of Property: t C' L lstbV LOT ( d --. <br /> Section#: 1/ Town#: IP 38 N Range#: 17 W Town of: Dan i d s 5. N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* En <br /> 3.51 �, <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: CCAr 1 \CGV ?t -I N <br /> Anticipated Start Date: (Home/Cabin:Commercial Business;Bedroom;Deck;etc.) N <br /> Building Contractor. Sewer Installer. �_ --- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY $ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> D 11/14+ A S,t,-1- 5 1 <br /> (2)No[ <br /> or iiiii/nm � J <br /> v cn <br /> $h ' - <br /> FeeRec: /5 <br /> i Check#: co,; <br /> g <br /> ZU Initials of site visit staf n ) l J <br /> Date of staff site visit: i—7/)D f� -I e a 'ten, <br /> IA I.IM ��2� DATE:1/�I�Z l 4 a ` tl u U <br /> APPROVED BY LAND SERVICES OFFIC x m cu = C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF . ;nd <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT co cc <br /> Inds <br /> Pagelof5 IIuu <br /> C��J) <br /> Burnett County,WI Land Use Application—Rev 12/2023 <br />