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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line to <br /> Permit Types and FeestPlease,check appropriate boxes). <br /> d <br /> Dwelling/PrincipalStructuve $300 Addition/Alteration to Dwelling/Principal Structure $200 � G <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <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 /> G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)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 /> 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: /I - <br /> 1 a. <br /> Property Owner's Mailing Address: s/ <br /> �r City State Zip <br /> Property Site Address: o <br /> Q c <br /> Contact's Telephone Number: 0 <br /> �4 d <br /> Contact's Email: t k 3 s m 1 3@ Gj t C© ✓)n :% <br /> **If staff has a question about this application,you will be nco tacted via email. Make sure your email address is ro <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q <br /> 5 <br /> Legal Description of Property: Z o C S Nf V %� Z w y b <br /> Section#: �2 q Town#:�O N Range#: / 5 W Town of: -9Gt c Ilc S n <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 statement): 5-5 5 <br /> N N o <br /> r 1 d <br /> Proposed Use of Structure/Addition: E k 12A ns r v o'f D e A c 1� y ` C� <br /> Anticipated Start Date: :3N r,,e- J 3K I ti (Home/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> z N <br /> Building Contractor: Sewer Installer: y t� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> YVt�ls-4 w�ee,� � F sSektic - ot}wMd o ' se -�-b0.�s X <br /> Fee Rec: <br /> z Check <br /> r <br /> C <br /> a <br /> Date of staff site visit:S 202 5 Initials of site visit staff. <br /> Q 3 <br /> APPROVED BY LAND SERVICES OFFICIA�,� DATE: Ic)W :-t-< <br /> C_j <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y '= <br /> vo co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT E3 <br /> h Gv� <br /> Page 1 of 5 f-,--� <br /> Burnett County,WI Land Use Application-Rev 11/2024 `��---� <br />