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- LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line cn <br /> Permit Types and FeesiPlease,check appropriate boxes)' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 W <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 C, <br /> .y <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 1 IWI 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 /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c ' <br /> T o <br /> Property Owner's Name: 1 <br /> p c W <br /> Property Owner's Mailing Address: f 0 Ct k '?C% S'4 `li t <br /> City State Zip � <br /> Property Site Address: -??(.1 3'1 C r-ej C*A4- Lo,.K t— L r\ CD <br /> Contact's Telephone Number: <br /> � d <br /> Contact's Email: (j n Q1 0,S S £y:v o th IDA'f-. ea M CD <br /> **If staff has a question abbut this applicati n,y6u.will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °� <br /> ao (V <br /> Legal Description of Property: Lc34 C 5/9 yl(.t f aab , C W l�l S SL S w)*-�Jr ll a 0 <br /> Section#: _Town#:_4(LN Range#: N W Town of: -Sc-o -�L N <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): IA I O � g d <br /> Proposed Use of Structure/Addition: 54,,t% 'a-'Q j r,.,Ae n kQA V) <br /> Anticipated Start Date: (Ho a/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: N�� Sewer Installer: tq IA- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> LA <br /> on <br /> O 'J k a l�.l�� �y I Zo25 m FeeRec:1� q� �P44,0 lem—-to z Check r <br /> a <br /> 7 �2 5 Initials of site visit staff. Cn <br /> Date of staff site visit: m <br /> APPROVED BY LAND SERVICES OFFICIAL��,{,� 4L - � DATE: wZ�J <.3 <br /> m — IV M <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o= cn <br /> cn `� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT —� <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />