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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> � m N <br /> Applicant Complete All Sections Below This Line to <br /> fl. <br /> Permit Types and FeesiPlease,check appropriate boxes) 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 ` <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <_ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 S <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> :o <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. . <br /> z <br /> 9 <br /> Property Owner's Name: L;Lo '�, o <br /> Property Owner's Mailing Address: Ziv�c -;4:1y,, S ft� ►- �� 5 �55� n N <br /> City State Zip <br /> Property Site Address: 15, <br /> Contact's Telephone Number: <br /> v <br /> Contact's Email: /��l�i C'7 r `t w ��%I p <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N 10 1-�-- <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °O W <br /> Legal Description of Property: <br /> (ey!oU t C,F Lca5 t 77cf o f Gov Lo 1 d <br /> #: Town#: _N Range#: W Town of- <br /> Section (�/-►/�> <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> a m <br /> Tax 1D#(l-5 digit number,found on tax statement): rZ-0 5>I x <br /> d <br /> Proposed Use of Structure/Addition: Co A. I ^� N <br /> Anticipated Start Date: S7,)9,4;f (Home/Cabin;Commercial Business;Be&vom;Deck;etc.) N <br /> Building Contractor..PIU(`_(�S &/I4 by'(46 n'Ll Sewer Installer )7) h5oo l hf,wi l h <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> m <br /> r 2' <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> ryluSf IYI�e� _ �c�-hur,�S <br /> A <br /> 4vtWw nb+ 40 �x(eecl 2 6-dr �►' SKEN-2�{-235 <br /> l Fee Rec3Ud• 0C) <br /> Oh 0 t y-ue fcl 40-4 \ tq+ n S-,Y i L-1'b1 z Check#: 0-.S4A, <br /> Corvh�-c�- u,pL �r r,Jl��l�� �-t-n�,►-K <br /> m <br /> 5 5 Initials site visi <br /> t it sta . <br /> Date of staff site visit: �3 ZDZ o ������ � <br /> APPROVED BY LAND SERVICES OFFICIAI 1C�F� D Zt25 '.3 <br /> ATE:- n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 2 o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 C' <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 �� <br />