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LAND USE PERMIT APPLICATION -Burnett Cn WI <br /> b <br /> Applicant Complete All Sections Below This Line 2 c <br /> Types and Fees�Please,check appropriate boxes) <br /> d � <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> ti <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 N <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° Q <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r" <br /> o <br /> Filling/Grading $150 Boathouse $500 E <br /> to <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 5. <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. $ <br /> b <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. <br /> z <br /> 0 <br /> Property Owner's Name: c � <br /> _ ^ 2� G 1 <br /> Property Owner's Mailing Address: ��� � w\ J�o N�Zip <br /> Property Site Address: 4 1 -1Q�.���'"'rV1 ���` �JO��+City u �`Stat�Jy��J� z o y <br /> Contact's Telephone Number: ���"`� 1 �-- ���J� Qr <br /> `' O d <br /> Contact's Email:��e� �� vJ�\��V,\PcA Q'oM <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov 5 b0 <br /> Legal Description of Property:LE17 J- C,S✓1)535-7 YC 1 30 P)-Uq re"rew" dX1V V Of `tK 53aXz <br /> d N <br /> Section#: Town#: _N Range#: I W Town of:�,Q C,n SdY1 <br /> —a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* E yy <br /> 1 % <br /> Tax ID#(1-5 digit number;found on taax,statement):�3 Le b on <br /> Proposed Use of Structur /Addition: l R r h (A1 <br /> Anticipated Start Date: l�l� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) S <br /> \ s <br /> Building Contractor: �Cr��c�T Sewer Installer: At -7?_" o� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 0/ <br /> a <br /> � Fee Rec:�.00 <br /> z clime-#: <br /> { act Sh <br /> z <br /> m <br /> v __` , <br /> Date of staff site visit: ZUZ S Initials of site visit staff: &0a <br /> APPROVED BY LAND SERVICES OFFICI DATE: z2 5 to u, - <br /> ro c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CD <br /> oo <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 C <br /> Burnett County,WI Land Use Application—Rev 11/2024 �� <br />