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LAND USE PERMIT APPLICATION — Burnett County, WI & CDr <br /> a. <br /> Applicant Complete All Sections Below This Line ' t <br /> Permit Types and Fees�Please,check appropriate boxes) a op -- <br /> d N <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD <br /> Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> c� <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(ly)Structures $350 91 <br /> Filling/Grading $150 Boathouse $500 <br /> co <br /> u, <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 /> ro <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:((:?w E W eL-7u - c W tv <br /> Property Owner's Mailing Address: 2- /7 CZ -rrL L 50�)&4oe- W( -!Nffo ) <br /> City State Zip <br /> Property Site Address:—A I TSB-DdZJYL.7-ML— o y <br /> N <br /> ' 7�.5-- S 2,D - 3s C,-7 a Contacts Telephone Number: <br /> J d <br /> Contact's Email: W e-n qar CD <br /> **If staff has a que is on about this-Application,you will be contacted via email. Make sure your email address is ro N <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov °Q <br /> Legal Description of Property: L-oT 3 GS/Yti 13�2 U I� TS tN 5C.-Vil,J �AIGg87 2 <br /> Section#: Town#: Range#:J W Town of: 12tA-S1L ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: AAC)rA(5 <br /> Anticipated Start Date: �. p ZU (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C�, <br /> 717 <br /> Building Contractor: ��� Swc�r� Sewer Installer: tCNc,7a,e, RLxet3h l INN y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z X <br /> - <br /> N1A.s+ m Q t,+ 15 � Se.-+b o�c,�C. b 0�M a nct � O-H&-r �-I- LG -S — <br /> Lwe,Q�,tn� b c,l,roo►ns pe.r S1+N-2S- 5 q <br /> 4-4 ► 0 4- Fee Rec: <br /> Je d SL)vvtl Maw be comb tk-j e j 9'l f 2025 z Check#:f 0 3 <br /> m <br /> Date of staff site visit:yl2�f�2 s Initials of s' a visit staff. > a. <br /> APPROVED BY LAND SERVICES OFFICI DATE: J z,95 -70 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 00 o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT @ ` L � <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 11/2024 <br />