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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line CD cn <br /> a <br /> Permit Types and Fees:Please,check appropriate boxes) i< 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 �� p <br /> Accessory Structure(Garage,Shed,etc.) G10 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(iv)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <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 ee. <br /> CD <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: <br /> Property Owner's Mailing Address: /frt'i i � 7 th <br /> City State Zi y <br /> Property Site Address:/ �J L� `�'`` (,�f � CA) <br /> CL <br /> Contact's Telephone Number: �/) ,�J70 U �U `�' <br /> d <br /> w <br /> Contact's Email: <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 followin address: @BurnettCountyWI.gov °Q <br /> Legal Description of Property:r !0-, <br /> Section#: / Town#: N Range#:�7 W Town of: L � <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number; found on tax <br /> rstatement): //,1 7 �f< N N d <br /> Proposed Use of Structure/ dition: .-7 ~� <br /> Anticipated Start Date: 1jo/y- _ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r <br /> Building Contractor: Sewer Installer: y � D <br /> S <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: orA <br /> m <br /> Q ME-Er ALL 5CT.3A1_V--s < �( <br /> Q /I/o Ti TD gt W9C-a Po(R HukAA'4V IlABtTATfoN, <br /> Fee Rec: L <br /> °z �: <br /> � CLI�SV 1 <br /> rA <br /> Date of staff site visit: 25- Initials of site visit staff:DB a ice' <br /> a U)W <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 DATE: 9 4ozs � = %=` <br /> S ej <br /> r~A <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF o 0 <br /> W,G P' <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 9 <br /> ro <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />