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LAND USE PERMIT APPLICATION— Burnett County, WI 07 <br /> a <br /> Applicant Complete All Sections Below This Line 0 <br /> CD <br /> Permit Types and Fees�Please,check appropriate boxes) ° <br /> 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 /> C� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r <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. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c <br /> z <br /> 0 <br /> Property Owner's Name: � <br /> 0 <br /> Property Owner's Mailing Address: d I / /lc & <br /> -7 City ate Zip <br /> Property Site Address: / !'t US - ( � C91 <br /> o N <br /> c <br /> Contact's Telephone Number: aCZD <br /> d <br /> Contact's Email: CC 3�7 CD <br /> 4 <br /> **If staff has a question a u his application,you wil be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov tl0 <br /> Legal Description of Property: ow[44kst&wSiR4 U 1 ILXAL <br /> Section#: 2,0 Town#: L N Range : W Town of: 74 K 1 f Q n C_ ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach taz system property page. <br /> 5 <br /> Tax ID#(1-5 digit number;found on tax statement): 144 �� <br /> // d <br /> Proposed Use of Structure/Addition:- e e. I ISA ej -� <br /> Anticipated Start Date" _ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> Fee Rec: «v`° <br /> rx <br /> Check#: 0 7 Z <br /> M' <br /> Date of staff site visit: _24)25 Initials of site v' it staff: ✓t-� <br /> n C— <br /> CD <br /> m M C <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: <br /> UPON APPROVAL: APPLICANT MUS OST COPY OF N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 <br /> Page 1 of 5 i--�---� <br /> Burnett County, Wl Land Use Application—Rev 11/2024 <br />