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LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line cNi� <br /> Permit T appropriate ) 'Types and Fees�Please check a ro date boxes <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 cu <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 /> r Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ! b \ <br /> i <br /> Filling/Grading $150 Boathouse $500 <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 /> -o <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. b <br /> o <br /> Property Owner's Name: r 1 <br /> Property Owner's Mailing Address: L014 e• ' 8Sc>1 W ( SLI 2. <br /> City State Zip <br /> Property Site Address: �`�I 3 VR� k r Dahl Jl,V Z o y <br /> Contact's Telephone Number: S• <br /> Contact's Email: b. •t t ►Y1 G�( 1 •Low I� ' <br /> I Q n d rl c at U A <br /> **If staff has a quests n about this application,Ou will be contactecYvia email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: A;BumettCountyWI.gov <br /> Legal Description of Property: ns YYl 2 Z 3 g Q U A 13 P Lot) <br /> Section#: a s Town#: D N Range#:��W Town of: LArl 4 pYt 2 V` <br /> *Attach additional e i needed or lent thy description OR attach a co o the deed OR attach tav systenr ro ertypage. <br /> Pa8 ,f .� 8 P PY f P P <br /> Tat ID#(1-5 digit number;found on tax statement): U, 5 b_1 Q <br /> Proposed Use of Structure/Ad on: Y N <br /> Anticipated Start Date: P1 1r r• (HomalCabin;Commercial Business:Bedroom;Deck;etc.) <br /> Building Contractor: MGw t nc �V1 a p VGi'b()Y1 _S Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CODIDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: > <br /> I�clsf m -F I a-P Sidi k-�rc& 4V r���Y l r <br /> m J <br /> [id n ted.S a lock 4UJ CW/) bq La I t I Z02s -� <br /> O3 Tr ex ed 64 GkiA aril �tu.S�- be (DnS+ra(,�d adj�c�-ri+ end Fee Rec:��= <br /> � t'1�-�- --�p (,P ° Check#: ff5�// <br /> ?cLrojj e,t 4e Akt t)t` -i n� S-�u tri.ga y <br /> n <br /> Date of staff site visit:y�/o�2025 Initials of site visit staff. a <br /> APPROVED BY LAND SERVICES OFFICIAL I`'I DATE: <br /> m<. <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o �_ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> 3 ' <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />