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r 1 r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a (t <br /> Applicant Complete All Sections Below This Line c c� <br /> Permit Types and FeestPlease,check appropriate boxes); ° <br /> G <br /> Dwell ing/PrincipaI Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 RK <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 /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 9' 1 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 1 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. 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: Gl c N <br /> / l _ o � <br /> Property Owner's Mailing Address: 721 �S fit f > -�?t X <br /> n v <br /> City State Zip co <br /> Property Site Address: m o N <br /> cj <br /> Contact's Telephone Number: ° <br /> Contact's Email: <br /> **If staff has a questiA about this applicatio ou will be contacted via email. Make sure your email address is p <br /> legible and your email provider will accept emails from the <br /> following address: @BurnettCountyWI.gov61 <br /> 0Q _ <br /> Legal Description of Property: 1/ � C� d N - <br /> y QD <br /> Section#: _Town#: 1 N Range#: _W Town of: �' � <br /> ( � 0 <br /> *Attach additionalpage if needed for lengthy description OR attach a ccoop`y�of the deed OR attach tax system property page.* ?�O <br /> Tax ID#(1-5 digit number;found on tax statement): `7 ( N <br /> 1 <br /> Proposed Use of Structure/ dition• NWA cYi <br /> Anticipated Start Date: S (Home/Cabin, ommercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: 0 <br /> o N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m 3 °0 <br /> z � <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> 076C-T I*L - SCT11�>ACk-S < P <br /> N0T To '6£ USED Vbrz .1-4VMAA) l }t31C�4?Ic�nl, <br /> Fee Rec:! <br /> z Check#: ��i—Y <br /> r <br /> 2� Initials of site visit staff: <br /> Date of staff site visit: 2�2�I <br /> •v cn m <br /> APPROVED BY LAND SERVICES OF _ ( DATE: 2 25 2S m 3 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTa <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />