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LAND USE PERMIT APPLICATION — Burnett County, WI a (ri <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees�Please,check appropriate boxes) � <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <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 °r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 3 Q <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 z�' <br /> 0 <br /> Property Owner's Name: W <br /> Property Owner's Mailing Address: Lt 4 S I ? n <br /> City State Zip <br /> Property Site Address: l�(t��;Q�Q e 1 �D( C o y <br /> 2. <br /> Contact's Telephone Number: <br /> 747-!¢9r�f CD <br /> d <br /> Contact's Email: <br /> **If staff has a question about this appl cation,you will be contacted via email. Make sure your email address is N M <br /> legible and your email provider will accept emails from the following address: BurnettCountyWl.gov =Ca,' W <br /> / 5' <br /> UQ <br /> LLegal Description of Property: o (� SC, �9�L��lG � D�� i'C�-�'��� d Q <br /> Section#: _Town#: �N Range#: I q W Town of: Q <br /> *Attach additional page if needed far lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> H H <br /> Tax ID#(1-5 digit number;found on tax statement): /Sg� C& a� d <br /> Proposed Use of Structure/Addition: S H <br /> Anticipated Start Date: (f/ome/Cubin,4fommercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: kk4� (i,16 t Sewer Installer: <br /> AREA.BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY � z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTER BELOW: <br /> bw r mu&4 tvta�e Sure Yvl ee 4 Sou--+- ► CrDptr+r I ne ye,- 6aJ rnd — <br /> ° J- U-V� kAk o at*S <br /> Imo. ukV.A -C,�r 6Mal--\ "i--oL+, <br /> Fee Rec: <br /> OND ' lur►�Ib t n °' Check#: hG, <br /> u Q U.Yti1�SS r-� i S CO►�►1Cc.�-e� -4o�� S�-p+� c �jS m ' <br /> Date of staff site visit: 202q Init• is of site v' it staff: <br /> j0 i 20ZL1 <br /> r <br /> APPROVED BY LAND SE VICES OFFICIA DATE: Q p <br /> m cUJ � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <._ -' <br /> (D ` <br /> - <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �C o 0 <br /> Page I of 5 sue- <br /> Burnett County,WI Land Use Application-Rev 04/2024 C <br />