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- LAND USE PERMIT APPLICATION - Burnett County, WI a I b <br /> Applicant Complete All Sections Below This Line o c <br /> Permit Types and Fees'Please,check appropriate boxes) 6, <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `., <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Q <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 /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150, Boathouse $500 Ilk <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. <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. A <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: /1/7/ e-r'! if I-- ! f ' •i' <br /> PropertyMailing ` CJ?5-G 7 ' , N (' D t 1 ' :Pro e Owner's Address: � �J' w <br /> 5f�t ,4 /C`/f City State Zip .° <br /> cn <br /> PropertySite Address: 9 C �] (1 �Qi o N <br /> Contact's Telephone Number: <br /> G J�— 3 / 71C P-- CD <br /> �y � d <br /> Contact's Email: j�% %��' ��W, ( N �% <br /> **If staff has a question about this applic on, ou will be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept a ails from the following address: @BurnettCountyWl.gov °O <br /> Legal Description of Property:Lo.rI or C,S/h `���) V(x �" �� / i'" `�l d 1. �V <br /> Section#: /5 Town#: 1(� N Range#: /_s"� W Town of: j-keli__&..)Al 338� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): ,j s / <br /> Proposed Use of Structure/Addition:!� SSC�I�-y (j:�& f -.3 <br /> Anticipated Start Date: O C,l ,„.y- (lame/Cabin;Commercial Business;Bedroom;Deck;etc.) '') <br /> . - <br /> Building Contractor: i'V A- Sewer Installer: 00 <br /> AREA BELOW THIS LINEFOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c: z V� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> C/ /Uo f 7it, d e us -fir /I v wl a.A A q d/7n 74o4, <br /> m <br /> y <br /> a <br /> -� Fee Rec: i' 41 <br /> ° Check#: <br /> z <br /> r <br /> -C <br /> Date of staff site visit: d/(// O 2- 1 Initi o ite v' ' aft': it /I U, mil <br /> ,g 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> /O//ZO Z7 < S <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF o `�' <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT I I J "m�_I <br /> Page 1 of 5 ;_ _-__^J) <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />