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LAND USE PERMIT APPLICATION Burnett County, WI <br /> Applicant Complete All Sections Below This Line _ wNi <br /> Permit Types and FeestPlease,check appropriate boxes) -100 a n <br /> C7 <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-C <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accesso Structure(Commercial/Industrial) $2 00 Addition/Alteration to Bunkhouse $150 <br /> De /Stair Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> o <br /> LR <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 c _ <br /> Filling/Grading 150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 W ' <br /> `NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. v, <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 /> 0 <br /> Property Owner's Name: p- <br /> Property Owner's Mailing Address: .A Z 1n e-_P �- n <br /> n City State Zip ' <br /> Property Site Address: QbUg 5 f' lm�s'i44-L <br /> Contact's Telephone Number: `/V 4I L, <br /> Contact's Email: ey-41!I lrD <br /> **If staff has a question about ttAsTpplication,you will be contacted v►a email. Make sure your email address is z <br /> legible and your email provider will accept emails from the <br /> following address:a a.BumettCounlyWI.gov <br /> Legal Description of Property: <br /> Section#: 23 Town#: L4 V N Range#: I W Town of: b(,ki d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> it <br /> o m <br /> Tax ID#(1-5 digit number;found on tax statement): Z 5-3� 6 V W x <br /> � e <br /> Proposed Use of Structure/ d ition: A— 4 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business: edroom;Deck;etc.) N <br /> Building Contractor: �J 1;-F101 Sewer Installer: Vh <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z S <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: X <br /> Fee Rec: <br /> Check#: U1355y <br /> in <br /> ro <br /> Date of staff site visit: In s of ite v' ' ff: AllCD <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ?�7?—s <,3 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF a , <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> Page 1 of 5 ./ <br /> Burnett County, WI Land Use Application Rev 11/2024 <br />