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� ro <br /> LAND USE PERMIT APPLICATION —Burnett County, WI r <br /> a <br /> <' b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> Permit Types and FeesiP/ease,check appropriate boxes) a. <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 /> k lAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ~ <br /> C� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)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 /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <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: lyl ,at A,--J Ll MA,/,��/ ITI <br /> o <br /> Property Owner's Mailing Address: 7 G <br /> City State Zip <br /> Property Site Address: 5S7k.►-e < <br /> Z o N <br /> Contact's Telephone Number: 7/� — _�� �—��/� 1> ° <br /> 1\1 0 <br /> Contact's Email: CI k</ 9 MR d>^✓ 3�:l�I jkey,`)• c'_� <br /> **If staff has a question a6out this application,you will be contacted via email. Make sure your email address is ro <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov Z. °Q <br /> M W co <br /> Legal Description of Property:UT I CW 4 41 I H V 2(a P 3n-1 CSC NE 4 N W�6�J�4 512� 7 d o <br /> Section#: _Town#:��N Range#:_�W Town of:DO-k tQ.r►� 6` <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> a ^� <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> d <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date:—Z/ l/.2 aG 0 / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor:�L� � Sewer Installer: N 0 F -C <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 �0 t <br /> v o <br /> Q tM eQ r- Att_ 5erggck-5• s <br /> n <br /> NOT 'IU -Be USED FoR, rfVVINAIV h}R$1779TloN, M <br /> Fee Rec: <br /> °z Check#: (a <br /> Date of staff site visit: 2�9 / 2(7Z� Initials of A—,- <br /> APPROVEDi visit staff:' a,�uo O °(� <br /> � <br /> BY LAND SERVICES OFFICIAL: DATE: �Z ��7 � o` _ 0 u <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />