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LAND USE PERMIT APPLICATION —Burnett County, WI s b <br /> Applicant Complete All Sections Below This Line C N <br /> w <br /> Permit Types and FeesiPlease,check appropriate boxes) 1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse d$25O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures 0Filling/Grading $150 Boathouse <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. ti <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. QD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Z <br /> 0 <br /> Property Owner's Name: PA A 2 ' 4 , �/- 8 <br /> s �� Cf <br /> Property Owner's Mailing Address: i-`�( � ` a C) � <br /> j �, n City State tip Iv <br /> Property Site Address:��n C) �tj N i I �-1� f� C�N�fa '✓"�( 4 `�f o_ <br /> Contact's Telephone Number: <br /> ( N a <br /> Contact's Email:Ul�(A e'1cA 1 S1& 1[ n, (�0Oni <br /> **If staff has a question about this app ation,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider wi I accept emails from the following address: @BurnettCountyWI.gov E b0 <br /> Of QQ <br /> of tion Descr Legal i Property: <br /> g p <br /> Section#: 4V Town#:_ N Range#:___I J W Town of: <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 z-1 �l w S t7 <br /> Proposed Use of Structure/Addition: `>C>1 (-&1'_ lsg i�mwy\e rS C-Ce c 50\� 1,.k 4-5402 -3 <br /> Anticipated Start Dater R ZO7,t (Home/Cabin;Commercial Business;Bedroom;Deck;etc) cf rA W <br /> Building Contractor: 1'rAC �tt'ei! $w' _A-6e 50JV5 Sewer Installer: N� 61 <br /> o � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Q w(,EET- �4cc SE7BAUCS n <br /> tz <br /> Q Not ge USED FOR tj~Al A .01TO tOAJ. > <br /> Fee Rec: <br /> M <br /> °z Check#:1( <br /> r <br /> •C <br /> En <br /> n <br /> m <br /> Date of staff site visit: Initials of site visit staff: DB a'il [nnl <br /> APPROVED BY LAND SERVICES OFFICIAL: < I DATE:q/9LA02$ Cn CO <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 CD <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />