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LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and FeesfPlease,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 /> CD <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 C, <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 jWl State Statute 59.692(ly)Structures $350 r" <br /> Filling/Grading $150 lBoathouse $500 ter\ <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> sv <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -o <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' <br /> z <br /> 0 <br /> Property Owner's Name: Svc <br /> Property Owner's Mailing Address: S LA) toZ 2. <br /> /C1ity State Zi <br /> Property Site Address: IA�C, DEPX W� s '�3 o <br /> Contact's Telephone Number: '2 DQ- ? 13--M <br /> Contact's Email: ( •J Q I ��gR\"V�C! )r1Jt-tr�►���t CIS' 1 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,ti <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q <br /> r� 5 <br /> Legal Description of Property:G , EX 5 2.W OC—E 2—W ``X ( ,(, %25 <br /> Section#: 14 Town#: _N Range#:--t I_W Town of. <br /> *Attach additionalpage 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): �2— w o <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date:3 W^` 2•025 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W <br /> Building Contractor: c1TI - � &�� SSewer Installer: -� N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o x <br /> u A tD C. ,Sweet berm (1-S-�r� aura.Q 1Jt wvgG , J <br /> m <br /> Fee Rec: 0 <br /> z Check#:�1 S <br /> m <br /> Date of staff site visit: i I 0 I��Z y Initials of site visit staff. n �J <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: �/L% ro CD <br /> CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFCD C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> 3 <br /> Pagel of 5 CD <br /> Burnett County, WI Land Use Application —Rev 04/2024 �� <br />