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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> < b <br /> Applicant Complete All Sections Below This Line <br /> Per Types and FeestPlease,check appropriate boxes) V <br /> O <br /> w <br /> Dwelling/Principal Structure $3001 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 K3 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 _ _-{\ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <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 /> *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. z Q <br /> o <br /> •y <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> Property Site Address: ff�f?�; —R?�4aAj <br /> Contact's Telephone Number: I zct—ci(o '073 O . <br /> Contact's Email: �0 2r r, - ' ' r n ,O i an o0 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address:@BumettCountyWI.gov N <br /> Legal Description of Property: (Lit Lot-, 11 E 4�`l€� ?nj! O tfL. De r'i'Y*'-, 4c�G�a�•�'i d N <br /> Section#: Town N Range#: W Town of: —if 4r,t, rc <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* �' <br /> p o � <br /> Tax ID#(1-5 digit number;found on tax statement): d <br /> �1 <br /> Proposed Use of Structure/Addition: I tu W <br /> Anticipated Start Date: (dome/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Ke Nr e) Sewer Installer: c iC�y N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 00 M�t-4 a�U S-e, -S <br /> I� <br /> -AD -tymm8 3 4&roNyvi <br /> ` I <br /> Fee Rec: 01 <br /> D �j Igo-} �o �x c e ed �D-F� 6�h4 aS-f Y��- 0 Check <br /> R1 0'n�I ��j m�-� , -22�5�3 '5/ cv 54rt <br /> d o <br /> Date of staff site visit:�2 q�ZOz�/ Initials of site visit staff:-KTT i- " <br /> APPROVED BY LAND SERVICES OFFICIA : DATE: Z �Z �Z / �!' � t J <br /> <,�E <br /> a4 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a o r <br /> ID <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT M <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application-Rev 04/2024 <br />