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LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) o S. <br /> d ti <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> Commercial/industrial Structure $300 Addition/Alteration to Commercial/industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) 5 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $2. 00 Addition/Alteration to Bunkhouse $150 <br /> o � � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> '. <br /> Filling/Grading $150 Boathouse $500 <br /> m <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z Q <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: c ce <br /> /� City Stat Zip y <br /> Property Site Address:_ �� j 3 7 ��t� Z o y <br /> N <br /> Contact's Telephone Number: �7t`S' ^ qq 'IS <br /> 0 <br /> i <br /> Contact's Email: reNV-2si ka-4 w \ Cpui-- <br /> **If staff has a question about this application.y u will contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following addresses: �iBurnettCounty.org and 6` <br /> @BumettCount-Wl.gov N <br /> Legal Description of Property:&O- L� sed / 6 <br /> Section#: 2 Town#: N Range#: W Town of: 5cc;'f"f �y <br /> *Attach additional page ifneeded_for lengthv description OR attach a copy of the deed OR attach tar system property,page.* A O <br /> i.o d <br /> Tax ID#(1-5 digit number:found on tax statement): 35ct72-- <br /> Proposed Use of Structure/Addition: f�d`f vi <br /> Anticipated Start Date: �} .,Z (Home/Cabin;Commercial Business:Bedroom:Deck:/etc.) O O LA <br /> Building Contractor: I ('Ce ( t'IS U✓� _ Sewer Installer: 1,111 iz -1 -4 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> QQ 144CEr A(—L SeT$QCICS. <br /> i <br /> Q /Ver la SE usEv �oR FFu.w4N HA8MRTICIV- <br /> Fee Rec: 1150 _ <br /> Check#: <br /> J <br /> 'J. J <br /> Date of staff site visit: y1lr81Z5- Initials of site visit staff: '05 `r <br /> = ll <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 DATE:�z ZyZT m a <br /> > < <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z N n <br /> 00 r <br /> m c rw <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 CD <br /> ��(2� Burnett Count Wl Land Use Application—Rev 3/2023 <br />