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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) j n <br /> d � <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure 1t( $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <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) $100 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 " <br /> z <br /> O <br /> Property Owner's Name: Bez r-m 1?,6E drcek i1n Zeo <br /> CS <br /> b <br /> Property Owner's Mailing Address: Z Jc /� O �( L lf I 5 a H /` ./ —I <br /> �/ <br /> City State Zip <br /> Property Site Address: Z,5 rO44 Ly, --s420d o y <br /> Contact's Telephone Number: —7/S —416 6 IR 3 <br /> CD <br /> Contact's Email: b lu 4r r N AltifQ l/- D <br /> **If staff has a question about this application,you will be co tacted via email. Make sure your email address is _ <br /> legible and your email provider will accept emails from the following <br /> //address: @BumettCountyWI.gov <br /> Legal Description of Property: �ld N .�YrU [ �3T l m 1tq Po�(3 " <br /> Section#:�_Town#: 39 N Range#: �4/¢ W Town of: "llS�( ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): /$Sa-e <br /> r r r <br /> Proposed Use of Structure/Addition: P6 r(� tT h L4 wtc /Z0 Ohl tdr l I ktQ .� <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck; c.) <br /> z W N <br /> Building Contractor: ► e �4 vllw Sewer Installer: 71,4d I�l fAettr�£ y _D CIO <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o M <br /> 0 No 6lbnfjs M -,M farce l as pfm4kd -f o �e used -For hwia, habl)u- ` � -- <br /> < -L <br /> 0C 1d+�;arlu.� U�2 �y(0- (CUP)I 40 �e OID +\&8 4W c,Pnc.fdA <br /> Fee Rec: - <br /> { O I I I ZDZ5• z Check#: <br /> �'J 2 a"4iorlal Sheds on -I-(�e �arc�l need a I ro usz Pernni+ by lJto25. <br /> rn l <br /> Date of staff site visit: 2I7/�zs Initials of site visit staff: D6 �Z(-A a n. <br /> e .D a)si <br /> APPROVED BY LAND SERVICES OFFICIAL.. C', kj � DATE: <, <br /> CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o <br /> C � <br /> 3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />