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LAND USE PERMIT APPLICATION — Burnett County, WI b <br /> N y N <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and FeesfPlease,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 C, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ~ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 I <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $3S0 c <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150-1 Permit Extension(1 Year Extension-Allowed Once) 1 $100 '— <br /> NOTE:After-the-fact permits(permit acquired after construction has begun) may cost up to three times the normal fee. 1:� <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. <br /> Property Owner's Name: <br /> 0 �--�ti�� n � `,A sue' <br /> Property Owner's Mailing Address: <br /> L� ( { City State Zip <br /> Property Site Address: ��� 5 —4tf nV4 , -1 q o N <br /> Contact's Telephone Number: 7( � <br /> d <br /> Contact's Email: {l2 I'( ��} �f 1 C-I c-C►---r-� CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails frore <br /> the following address: @BurnettCountyWI.gov ° °Q <br /> Legal Description of Property: V �iA v � d <br /> Section#:�Town#:�N Range#: cy—t/W Town of: G -�O-;,i <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o � <br /> x <br /> Tax ID#(1-5 digit number; found on tax statement): �c d <br /> Proposed Use of Structure/ ddi 'on: / ' <br /> Anticipated Start Date: r } -(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) �) 9 <br /> !� "E' 1 <br /> Building Contractor:�B;rla 9�i Sewer Installer.jQL 3� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> Dmz+ ► f ac i se-I�oar.�s < <br /> PIP/ v� <br /> �Dw ,i►�j yio� -b �exc eel 2 <br /> bedr S/#v-22- 229 <br /> a Fee Rec: 3DD� <br /> OD3 �IDF� re S�tn W <br /> jt z Check#: (o D <br /> a <br /> m <br /> n <br /> m <br /> Date of staff site visit: 3 GSJZ5 Ini ials of site visit staff: 4-LID <br /> m <br /> 77 <br /> APPROVED BY LAND SERVICES OFFICIA PAPDATE: ZOZS m m : <br /> <.3 z <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF IM � M <br /> 00 a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT K <br /> C <br /> CD <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 ^� <br />