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;n ro <br /> LAND USE PERMIT APPLICATION -Burnett County, WI b <br /> U <br /> Applicant Complete All Sections Below This Line - t! <br /> Permit Types and Fees�Please,check appropriate boxes) b <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 p <br /> E <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(1v)Structures $350 r' <br /> c <br /> Filling/Grading $150 lBoathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <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. z <br /> z <br /> Property Owner's Name: S2Cv� +1 �4 Trna dl/1 �L���� R :A <br /> Property Owner's Mailing Address: Co 60 zZ- fv 7 n <br /> T ity State Zip <br /> Property Site Address:�GIK 1Q(? C �33y A410 G'i�/�►T-Z� � <br /> Contact's Telephone dumber: -/ 7 �-7 U C- <br /> e <br /> Contact's Email: �C✓1 �� \U l P �� . yl <br /> **If staff has a questio about tT is a plication,you will be contacted via email. Make sure your email address is ro <br /> legible and your email provider will accept emails from the following address`: �:BurnettCoun/tyWI.gov � <br /> Legal Description of Property: (A) S W � X S4 G 6 X tt l Z d <br /> Section lF570i, Town tf: N Range tt: b W Town of: 0C\ <br /> *Attach additional page if needed for lengthy description OR attach a cope of the deed OR attach tax s.iwem property page.* LO <br /> Tax I D#(1-5 digit number, found on tax statement): <br /> Proposed Use of Structure/Addition: � <br /> Anticipated Start Date: l'_ C( 4 11. 2-0 (Hone/Cabin;Commercial Business;Bedroom,Deck;etc.) O <br /> c Building Contractor: Sewer Installer: w <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z Z D <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G x v <br /> s <br /> Ell <br /> n9EET AC(- SE'rSACk,5- <br /> T <br /> OZ �loT Tb Be uSE� FOR WAB/T'fj olv- <br /> T <br /> Fee Rec:�_ <br /> © RPPo FoR Rlx,9.eST lay 5/IS'z025. ° Check#: <br /> z <br /> Date of staff site visit: Initials of site visit staff: 1)B CL <br /> � CO <br /> APPROVED BY LAND SERVICES OFFICIAL: a 1 DATE: r{�tl12o25 3 <br /> c � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF � ^�00 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD C- <br /> � = <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />