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LAND USE PERMIT APPLICATION — Burnett County, WI G r <br /> a � b <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and FeestP/ease,check appropriate boxes), ° <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i, ) <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..W <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 'p�9 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 iu <br /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o N <br /> Driveways/&Campground Structures $125 F WI State Statute 59.692(iv)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) $100 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ro <br /> z <br /> 0 <br /> Property Owner's Name: o .D <br /> 0 <br /> Property Owner's Mailing Address: V t�S j n <br /> City State Zip <br /> Property Site Address: dy,7 5'71 el.;, <br /> Contact's Telephone Number: i 0 ` 1_419 <br /> Contact's Email: ��l /►�'�f it �j Al 0 01 mv,ai r'• C V r"T <br /> **If staff has a question about application,Xu will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov <br /> Legal Description of Property: 9,0,4 A114� d <br /> Section#: 2$ Town#: N Range#:_L;!�_W Town of: ��1h s��ig <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): .5' Qp <br /> C7 <br /> Proposed Use of Structure/Addition: AyPj1,,f j bk1 •� <br /> Anticipated Start Date: ot (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) i 1 <br /> Building Contractor: Sewer Installer: y Q to <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: v X Z °� <br /> ►(,' pux is nQ -exceed <br /> ✓K4 -6 2 be4rvcMs P-er- 6. � <br /> J <br /> m <br /> O CON,, CV Up c WS?cc-MR fo R A)0C6 5 H R y ►t Iw4x If"S. <br /> Fee Rec: <br /> °z Check#: v <br /> r <br /> -C <br /> X <br /> m �J <br /> ff <br /> Date of staff site visit: 3 5 Initials of site visit staff: 3 Cn W <br /> e co c 3:2- <br /> APPROVED BY LAND SERVICES OFFICIAL: ( DATE: w "1 2025-- < 361� CD <br /> v <br /> J <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF M all 1z <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Fir <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />