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LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Linea .p <br /> Permit Types and FeestPlease,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 K <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 /> C C <br /> Xe Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 1 jWl State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 lBoathouse $500 <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. or <br /> z <br /> 0 <br /> Property Owner's Name: tY,'I'A C A 0 <br /> Property Owner's Mailing Address: IZ03 N <br /> / City State Zip <br /> Property Site Address: 119Z eiOCA- U,0_11 le l <br /> N <br /> Contact's Telephone Number: le!Z- Z-4e - Zft Z r? <br /> C7 <br /> Contact's Email: n C F [4> t/,-0'Ylat I C/'0 rK == <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N - <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q N.% <br /> 5' <br /> Legal Description of Property: 0*7-0 Z S •-Z-y0-/Y-.36 :5 6 c —Dbfa --6/y4 d o 0 �i <br /> Section#: Town#:ON Range#: /c' / W Town of: Seep- <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C, <br /> W o <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> a C7 <br /> Proposed Use of Structure/Addition: x c'/C .� <br /> Anticipated Start Date: I/-l3--Z (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> a <br /> Building Contractor: Pc e�zi a`� n Sewer 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: z z <br /> v <br /> O /V a4 a c t S,�ack - C r i 63 F� Se,-�t J -b -Nle Se�-h C X . e- <br /> 4A n k be c/k 4 he mwtd.i ajQ Q d -b -mow ►ems -b NLX 4 -A-W S <br /> �. <br /> Fee Rec: <br /> z Check#: <br /> r <br /> -C <br /> a <br /> Date of staff site visit: Z I Z 2# Initials of site visit staff—+ > Q - <br /> CD <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: I Z Z 2OZ-/ CC) W <br /> 3 < <br /> o <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTCD <br /> 3 r <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 �--- --� <br />