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LAND USE PERMIT APPLICATION- Burnett County, WI r <br /> < _ b <br /> A licant Complete All Sections Below This Line nUPI <br /> ' <br /> Permit Types and Fees(Please,check appropriate boxes); CL <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 v <br /> O <br /> F <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 0 <br /> Filling/Grading $150 Boathouse $500 <br /> v7 <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 /> *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. o <br /> z <br /> 0 <br /> Property Owner's Name: ( 6__ <br /> , <br /> o ` � <br /> Property Owner's Mailing Address: 7 7 �ll I UPS cj 0( w n op <br /> ity State Zi <br /> Property Site Address: 279S70 0DukITY l�D j4° '5 0/SLIL t,S l �'�$0 l o ti <br /> Contact's Telephone Number: 77 S--L4(p 73-3 a <br /> N d <br /> N w <br /> Contact's Email: <br /> **If staff has a question about this application,�ou 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 S °0 H <br /> i <br /> Legal Descrintion of Property: F!( (� 5 J�� (JU j t,Q(n�C, po1.i----r- -�-fir r <br /> Section#: _Town#: 40 N Range#: _W Town of: `j;I(20 1 do <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* N <br /> Tax ID#(1-5 digit number; found on tax statement): 3Zi(g k 3z1�o 6 x <br /> 0 <br /> Proposed Use of Structure/Addition: t pEA ! ,�q -;I; �}�t;N ltl pwFl S•.t'ice. y <br /> Anticipated Start Date: ^f -o jy j (Home/C��Commercial Business;B droom;Deck;'etc.) <br /> Building Contractor. Cf1iJ 'Ske'Q� 6f4s Sewer Installer: o N <br /> AREA AEI:*iflg�F'OR LAND SERVICES STAFF COMMENTS/C NDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (D ✓BEET r9Lt SETgr9CIC S < `� <br /> A-zr T'D je U96P OwZ hmoml Fee Rec: � <br /> z' Check#: too <br /> r <br /> r— <br /> Date of staff site visit: q e/25 Initials of site visit staff: <br /> Cn <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Zo Z <br /> < <br /> PONi`APPROVAL: APPL 'ANT MUST POST COPY OF a o -- <br /> S1 N PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 CD <br /> Burnett County, WI Land Use Application—Rev 11/2024 ---� <br />