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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and FeestPlease,check appropriate boxes): ° <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> \ d Q <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk iBunkhouse $250 °_ G <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(iv)Structures $350 S <br /> Filling/Grading $150 lBoathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 W <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: o <br /> Property Owner's Mailing Address: ��eVl- w S`f 75/ n <br /> City State ZipCon <br /> Property Site Address: <br /> yy o <br /> Contact's Telephone Number: <br /> 0 <br /> Contact's Email: r—e-+�� o ryn G r <br /> **If staff has a question about this application,you will be contacted vil email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov E. 0q U <br /> 0 <br /> Legal Description of Property: t? N <br /> Section#:�Z Town#: N Range#: U W Town of: S L o ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): 1 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: e X r,r S vi c (Home/Cabin;Commercial Business;Bedroom;Deck,etc.) 47 <br /> -� <br /> z <br /> Building Contractor: Sewer Installer: y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> ril <br /> u�e 1-7cJ l <br /> Fee Rec:� <br /> °z Check#: U �01 <br /> r <br /> -C <br /> Date of staff site visit: UZ5 Initials of site visit staff: k <br /> � CID <br /> /'/n �y/ W I`t�) �\ <br /> APPROVED BY LAND SERVICES OFFICIAL]( � ` DATE: ZU� , C7 � �J <br /> Sao l! <br /> c �U <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Na <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT n�.r�i] <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />