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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 FeestP/ease,check appropriate boxes); <br /> Dwell ing/PrincipalStructure $300 Addition/Alteration to Dwelling/Principalstructure $200 CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <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 /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° PJ <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(1v)Structures $350 S �� <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) 1$150 113ermit Extension(1 Year Extension-Allowed Once) $100 P. (a <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: i • o 1 <br /> Property Owner's Mailing Address: �D Wr 7 1v2 �. n <br /> �� City State Zip <br /> Property Site Address: �JC 3 Q 1 -/�D�[e re �cY <br /> Z o <br /> C C <br /> Contact's Telephone Number. <br /> Contact's Email: 10 T ;�clGi^ l <br /> **If staff has a question abo—UY this application,y&will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> +� <br /> �1 o <br /> Legal Description of Property:_ a3 ,5�8 <br /> Section#: / Town#: <br /> �N Range#: 7 W Town of: S <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): 42-d '9 Zz- -� <br /> Proposed Use of Structur /Addition: S}0 C AQ(' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> x <br /> N <br /> Building Contractor: Sewer Installer: CAy o <br /> AREA BELOW TIIIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z G <br /> v <br /> O YKEeT Ac,[,. 5£t3►4CLCS � <br /> O ►3u.tw,W G Ta 8t /DER�.0 7?l L7 3 Y (a�l�zn zS tF o V Est � Fee Rec: <br /> ud Sok.9 Re FEET . ( S�e ff7-AtHF0 Ptfo n). z Check#:_► o v <br /> m <br /> Date of staff site visit: initials Initials of site visit staff:be <br /> Q <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: CD <br /> • MUST POST COPY OF ro ° N � <br /> UPON APPROVAL. APPLICANT 0 cm <br /> ,00 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 C <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />