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LAND USE PERMIT APPLICATION —Burnett County, WI a' CD <br /> 9 r <br /> < <br /> Applicant Complete All Sections Below This Line 0' N N <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> n. CIi <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 K <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 /> n � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <° N <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 fee. <br /> It <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. �7 <br /> z <br /> 0 <br /> Property Owner's Name: o {V <br /> Property Owner's Mailing Address: Q � J7 `fir /plp S N <br /> City State Zip <br /> Property Site Address: -9ZZ? cOfy C od M 9-jr < <br /> o c <br /> Contact's Telephone Number: c!5�;l <br /> d <br /> Contact's Email: kSA1Q4SC, g8e. tiD 114�i41 �(>ryl � <br /> **If staff has a question about this application,you will be contacted via email. sure your email address is <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov <br /> � N <br /> Legal Description of Property: / �f o <br /> Section#: Qj' Town#: N Range#:_ 2 W Town of: <br /> T <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): W o <br /> � � d <br /> Proposed Use of Structure/Addition: AA& ' V),J '16 < /A er-U,+`1 .� <br /> Anticipated Start Date: ,S(f/VL a Q $ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W N <br /> -� <br /> Building Contractor: 564 Sewer Installer: y N <br /> 5 <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 <br /> Z bums pR-r Sti s 2 ZO l9 m <br /> l/wn Lit 17U �'1'� �1 .�' W �,�'�(✓ 1 Ins - ►' -KOr 0.t'ly YUI LdSaq 1 FeeRec: �•�� <br /> r / z Check#: 2 7(� <br /> r <br /> '�7 1112D2.S. <br /> OqS.Q,fl�'tC -�Ank �I� '� 6e SkCl �-� <br /> Date of staff site visit:5/L912o2,'5 Initials of site visit staff- m <br /> v r <br /> APPROVED BY LAND SERVICES OFFICIAL:-ed,G>✓i? &47—j� DATE: 5 ZZ ZS :;2 W <br /> NC <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF I c Ma <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 11/2024 <br />