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LAND USE PERMIT APPLICATION - Burnett County, WI 6 b <br /> a. <br /> �. CD <br /> Applicant Complete All Sections Below This Line c� <br /> Permit Types and Fees:Please,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 S <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 5 p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 . <br /> ti <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 5 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <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: <br /> 0 <br /> Property Owner's Mailing Address: dX �� J �` W r) <br /> ` City State Zip ° <br /> Property Site Address: 1; cI L i<a )L o N <br /> Contact's Telephone Number: 1 <br /> r � d <br /> Contact's Email: 'A' 1-KA Q K-�^ <br /> **If staff has a question about this aplAication,you will be e6ntacted via email. Make sure your email address is 64 <br /> legible and your email provider will acceptemails from the following address: @BurnettCountyWI. ov PQ <br /> Legal Description of Property yZ'3MP-53 � `O&W&5) d 90O <br /> Section#: Town#:� N Range#: W Town of: SW:5S El. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* y <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> d <br /> Proposed Use of Structure/ ddition: Y GC�e H <br /> Anticipated Start Date: 7Q f V-e�I t, (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) N <br /> 2 <br /> Building Contractor: Sewer Installer: N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> v <br /> Q meek a.It S&baCXS X _ <br /> Fee Rec: <br /> °z Check#: <br /> r <br /> C <br /> � p C <br /> Date of staff site visit: l0' 1 ' Zs- Initials of site visit staff: LE a 3 <br /> APPROVED BY LAND SERVICES OFFICI DATE: <br /> UPON APPROVAL: APPLICANT MU POST COPY OF ?� <br /> u <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />