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0, 1 r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This LineCD cn <br /> Permit Types and FeestPlease,check appropriate boxes) a <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 U �\ <br /> G) V" <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk 113unkhouse $250 <br /> c-- <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(ly)Structures $350 r" <br /> Filling/Grading $150 113oathouse $500 o U1 <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 /> CZ CD <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. z <br /> z <br /> 0 <br /> Property Owner's Name: A _ o <br /> Ilej6440441V � b <br /> Property Owner's Mailing Address: I �� i f '!0 E! n <br /> City State Zip <br /> Property Site Address: �/l"LW <br /> Contact's Telephone Number: , ` ' ! 57 7 ° <br /> Contact's Email: �- <br /> **If staff has a question about this applicat' n,you will be contacted via email. Make sure your email address is 04 <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.govUQ <br /> °O <br /> Legal Description of Property4k d 6W en add U Y • Lo d <br /> _ A <br /> 39 <br /> Section#:��Town#:�N Range#:_LAW Town of: D v) <br /> A <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): N <br /> 1 G <br /> Proposed Use of Structure/Addition: f /{s Ut✓' G�' Go .� C—) <br /> Anticipated Start Date: (Home/Cabin;CommerMat B iness;Bedroom;Deck;etc.) .I <br /> N <br /> Building Contractor: Sewer Installer: O �+ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY M z LJ� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z M <br /> o <br /> D aaracy ftA. S iA F(0eP K4-j 1 i O L <br /> m <br /> a.0 p-J-W r �C ,acl S I5b.Do <br /> Fee Rec: <br /> © �,���� Cl2 � -�( I UPI,YYL(.V►� -I-�"'�1�� °z Check#_Xc(.J l7 <br /> 1�r garage Can Ize (.aced c�n�cre-fie Slab a� l�n� as - - <br /> �7 r•- <br /> Date of staff site visit: 7 CU <br /> Init'als of si a visit staff. <br /> a c_ <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: b 124 ZS m C <br /> Z z:UPON APPROVAL: APPLICANT MUST POST COPY OF y a <br /> 00 o <br /> CD C o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application-Rev 11/2024 �--_-� <br />