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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This LineCD cn <br /> Permit Types and FeestPlease,check appror.date boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> s, <br /> ommercial/Industrial Structure $3 Addition/Alteration to Commercial/Industrial Structure $200 �� p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 G <br /> Accessory Structure(Commercial/Industrial) 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 /> 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:✓ ,e+ o <br /> Property Owner's Mailing Address: t w n . <br /> City u State Zip <br /> Property Site Address: �(<e I 19A 1.)�0S 2 v G o N <br /> —, s�r 1� a <br /> Contact's Telephone Number: <br /> G <br /> Contact's Email t �-0 VWY,e i 3 C.t]►'1r� � <br /> **If staff has a questio about this application,y will be tacted Via email. Make sure your email address is ro <br /> legible and your email provider will accept emai from the following address: @BumettCountyWl.gov °Q <br /> PC] /V <br /> Legal Description of Property: <br /> s� <br /> Section#: <br /> Town#:_&LN Range#: _W Town of: <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): ZOO <br /> 5 <br /> Proposed Use of Structure/Addition: t2 <br /> Anticipated Start Date: (Home/ i t <br /> abin;Commercial Business;Bedroom;Deck;etc) <br /> P x ! Aq <br /> A _ <br /> Building Contractor: Sewer Installer: rhN <br /> N C <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o �, <br /> lO 1'1htET �9LL 5t"TgACXS rp <br /> < G <br /> OSEPT�c TwNiL Lip 'Tt3 IJ SEcut2E1� 134 LocK cHill�v $y (a�lS�1o25 y <br /> �o <br /> Fee Rec:� <br /> °z Check#: <br /> r <br /> •C <br /> z <br /> r <br /> Date of staff site visit: 5129l25 Initials of site visit staff: bS C <br /> Q � <br /> CD <br /> APPROVED BY LAND SERVICES OFFICIAL: ( DATE: 5I�IZozS c <br /> o m o (nnl <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 j cm u <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />