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_U 0- by <br /> 10 <br /> LAND USE PERMIT APPLICATION—Burnett County, WI � 0 b <br /> N <br /> Applicant Complete All Sections Below This LineCL <br /> xn <br /> Permit Types and Fees fPleose,check appropriate boxes) 1 <br /> w .J <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 V J NI <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ��p <br /> Accessory Structure(Garage,Shed,etc.) 150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 c U� <br /> Filling/Grading $150 Boathouse $500 <br /> w <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 /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 1D i <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 — Z <br /> Property Owner's Mailing Address: JIM (��� �'�� t�'� /✓ 3 . <br /> City State Zip K <br /> Property Site Address: c ti <br /> Contact's Telephone Number: �7 — S- 4q 3 �' c <br /> J` v <br /> Contact's Email: �5 kC rvrW:—j k w N � <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is Z <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov 00 <br /> Legal Description ofProperty:u (r7dlUl�LCY� �t,� t�`� SEC Z� �CTf j d <br /> Section#: Town#: 4f N Range#:�t _W Town of: (10 I SS <br /> *Attach additionalpage if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> pq <br /> Tax ID#(1-5 digit number;found on tax statement): 2�o'7j N <br /> � " d <br /> Proposed Use of Structure/A dition: q Lee <br /> Anticipated Start Date: ( ome/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> /U,� _ w <br /> Building Contractor: �C ty=�C� Sewer Installer: ,,, p <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> tz <br /> Q MCET qLL sero?wks, < � <br /> O NOT TO aE USED pop ►+Vw�P,N IiAgIrAT IoN. �' c <br /> H <br /> >Tj FeeRec: <br /> ArF0 FoR 4DCRrSf .8`J (011 j2o25_ <br /> z Check#: a S h <br /> O sX �f6' SlfEp Tb 5C PERwkI rTI-0 SY 05/ /Za25. <br /> v {�I <br /> Initials of site visit staff: <br /> Date of staff site visit:�5/ZS 'Z>3 ........, <br /> !� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 5�(o�2m2S m cu <br /> UPON APPROVAL: APPUCANT ST POST COPY OF 5 NM <br /> 00CD <br /> _ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTCD <br /> C <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />