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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> .» N <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and FeestPlease,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 J <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 $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 0 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> � I z <br /> Property Owner's Name: I)uJA`riuE ^ SHE t.C.,LE 'SAC O$S to N <br /> 0 <br /> Property Owner's Mailing Address: 24eV7 GW �s Wl 4 43 n 6• <br /> City State Zip <br /> Property Site Address: $Mhe *5 A 60vt o y <br /> Contact's Telephone Number: —1 i -33$ '7-9 313 <br /> r d <br /> Contact's Email: ma't Cows J <br /> **If staff has a que n about this application,yo16 will be contacted via email. Make sure your email address is N ro N <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWI.gov °Q Ct <br /> 5' <br /> d <br /> Legal Description of Property: 7-A931 0^16erg Q8 • N <br /> Section#: Town#: 3j N Range W Town of: N�EhIOIV IJ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page. <br /> O w <br /> Tax ID#(1-5 digit number;found on tax statement): I Z.550 0 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: APR" Z5 (Home/Cabin;C i kercial Business;Xedroonu Deck;etc.) W <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: rn <br /> r <br /> 0 <br /> 1)MPej au Semis <br /> O Nof 4j i2e ,y hum66 <br /> m <br /> 94(m14f'��d 'N✓ re�/1� GO(C<A&I , SV 0Fee Rec: <br /> p� z Check#: g�9 <br /> r <br /> z <br /> m �� <br /> 3 1 3�t1�2027 <br /> Date of staff site visit: 4- g 25 Initials of A visit staff: 4- b a -� <br /> 3 2�2QZ5 - CO W m <br /> APPROVED BY LANDS R ICES OFFICIAL: DATE: Zy 20Z5 <.3 <br /> mCD <br /> r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o <br /> � C € C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, W1 Land Use Application- Rev 11/2024 <br />