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LAND USE PERMIT APPLICATION — Burnett County WI <br /> a � � <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and FeesiP/ease,check appropriate boxes) a <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 $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(iv)Structures $350 r" <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 HiPermit Extension(1 Year Extension-Allowed Once) $100 <br /> o <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,andfees. <br /> � <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: 0 <br /> Property Owner's Mailing Address:_ � n './ � � � <br /> Property Site Address: c <br /> o Contact's Telephone Number: 6�2 <br /> d <br /> Contact's Email: <br /> **If staff has a question about this application,}you wiirl be contacted vi email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: (dBurnettCountyWI.gov <br /> Legal Description of Property: A vD,W4 Wr GVT' �✓ g N <br /> Section#: S Town#: N Range#: W Town of: �C 9 CS oL�/ <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> H <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> �•\ `� C7 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date:_ d2 a <br /> p n�_ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: S N L:-x- Sewer Installer: C <br /> AREA BELOW THIS ITNF R LAND SERVICES STAFF COMMENTSIC09DITIONS ONLY M <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELO > <br /> e mi-� �C % <br /> -�ertS ��c�O�re `71112ce4 <br /> pef <br /> W <br /> Fee Rec:_l�1LL <br /> O DW -�/� 1 S l�tS►Vl� �- ,(,� ( f,rt�! 4,r .lk I a lie 56'I6 MUS-} wt.e e 0 Check#: <br /> r� <br /> V ay�� lY1Sp2L-br 4b (AO-Wn ` -�• �e-,-rye'"� <br /> Date of staff site visit: / �2�J Initials of site visit staff: t\h4-L6Cn <br /> cri <br /> 9 <br /> co <br /> APPROVED BY LAND SERVICES OFFICIAL. 91VZ&�__DATE: 25 �'m N <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 `' � <br /> 2,1 Z CD a <br /> CD � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 9 CD <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />