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LAND USE PERMIT APPLICATION —Burnett County, WI <br /> Applicant Complete All Sections Below This Line en <br /> Permit Types and Fees:Please,check appropriate boxes) °- <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 o C <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ 0 <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)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 fee. (` <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. o <br /> z <br /> Property Owner's Name: r 277 FjZ j 15 T: 4-t_ W <br /> .��, <br /> 7f7tt5 a 6-1 <br /> r <br /> Property Owner's Mailing Address: ���j /f� /�V �� k 3 Ci <br /> City State Zip <br /> Property Site Address:___121 1-3�0 Fe'ir <br /> Contact's Telephone Number: 7 �-7 �' ej- G�l/L 12OJ���j¢l�° s a <br /> Contact's Email: el <br /> L C (L�, �/(/ /Z.S .V t')/ (��_ ev&XA <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov N <br /> ' N <br /> Legal Description of Property: _7 01C44, /V7719-6V,0,"1 d N w <br /> N <br /> Section#: Town#: N Range#: W Town of: S <br /> *Attach additionalpage if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Cn <br /> H H <br /> Tax ID#(1-5 digit number; found on tax statement): $�3 L) -2 N .moo <br /> d <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: S-— z fi 2_5 (Home/Cabin;Commercial Business:Bedroom;Deck;etc) <br /> Building Contract or(Id f"'IrOf -7l eu1.j� 191'1s�wer Installer: <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> e <br /> O NdT -To $E wreP Foa t u�u4N H,1V lTATrO,V. <br /> O SEP t!c Tiwk t 10 S "FO BE SCcuR 1zD 13y L,a c.k d C4091 N 8 y (D//S/Zo2 5. � <br /> 0 F'ou..bv-i ALL Coal rn o.)S of ►OIR -2q-29 Fee Rec:� <br /> ° Check#: <br /> r <br /> m� <br /> m <br /> d h <br /> Date of staff site visit: 5/IZ1zS initials of site visit staff: D$ H Lip <br /> APPROVED BY LAND SERVICES OFFICIAL. 1 DATE:UPON APPROVAL: APPLI NT ST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTco <br /> Page1 of5 �—�—� <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />