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• • LAND USE PERMIT APPLICATION — Burnett County, WI a 1 <br /> Applicant Complete All Sections Below This Line 0' <br /> Permit Types and Fees(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1,___k <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure c.- FD <br /> Accessory Structure(Commercial/Industrial) $200 )( Addition/Alteration to Bunkhouse :may <br /> c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk )G Bunkhouse $250 P. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 �, <br /> Filling/Grading $150 _Boathouse $500 <br /> v) <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 0. (1 fl <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. �}{J <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. r <br /> z <br /> • <br /> c _ p <br /> Property Owner's Name: W : � o0. <br /> Property Owner's Mailing Address:q .--). ,�r le) =J``�' ��� 31 GU I'\� //Q 1 <br /> �c City State Zip <br /> Property Site Address:C I' II��✓�� 1 i�'" <br /> Contact's Telephone Number:(()J/ -23E-6. a.N <br /> n' <br /> � C <br /> Contact's Email: { ��,- Jc / . �I (,LCIA <br /> **If staff has a question abhis application,you v be contacted via email. Make sure your email address is N b --.1legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0 °O �1 <br /> Legal Descri tion of Property:LOT I C -7 viy 142 e y)C,31(P (NE Nw -+��Ily3)l� 0. N b <br /> Section#: �j Town#: 9 N Range#: /6 W Town of: ,11/4_/P„�Z 5 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7kk En <br /> Tax ID#(1-5 digit number; found on statement): <br /> 1. <br /> Proposed Use of Structure/Addition: C(A 1 °0 H W <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) g <br /> x , U <br /> Building Contractor: Sewer Installer: y N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: zpzi <br /> v <br /> A <br /> m <br /> 4 <br /> m <br /> Fee Rec: -- C:6 <br /> ° Check#: CJ511 <br /> z <br /> L <br /> Date of staff site visit:C0702,11 Initi Is of site vi ' staff:<T a <br /> EMI <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE:l q'2U2 l .0 ._ <br /> .g, g3 n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF cn o C:3 Inn <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT tc <br /> Ifiril <br /> Pagelof5 co <br /> Burnett County, WI Land Use Application—Rev 04/2024 .)) <br />