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LAND USE PERMIT APPLICATION — Burnett County, WI b r <br /> Applicant Complete All Sections Below This Line N <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 a <br /> o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o cuq <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <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. o <br /> z <br /> _ a <br /> Property Owner's Name: YV (-W!i v h 51 t a rs i'� �- 2 n r�t?� T o <br /> Property Owner's Mailing Address: 3� y wES i �xGKso�f ��� ���h ��� "mil ✓�1�?f��L b '� r <br /> 2g I d 1 Q j lhnJtr R o (�/pols G City State Zip cn <br /> Property Site Address: � <br /> Z � y <br /> 43 <br /> Contact's Telephone Number: 7 5-Lj.3 y 9,5-'6 r' <br /> C7 <br /> Contact's Email: W°k��P l�`'�'� � 5M° t C-CfV0�' � "- <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ro J <br /> legible and your email provider will accept emails from the <br /> /following address: @BurnettCountyWI.gov o: i <br /> Legal Description of Property: C E- �" o <br /> N N <br /> Section#: V) Town#: 3 1 N Range#: W Town of: W't-9%MAr3 h 1110J <br /> *Attach additional page if'needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> a w <br /> Tax ID#(1-5 digit number; found on tax statement): 2 -7 -5-7 0 W <br /> 0 <br /> Proposed Use of Structure/Addition: S/-Vf-°04— <br /> RI <br /> Anticipated Start Date: / Z V 7-5— (Home/Cabin;Commercial Business;Bedroom;Deck:etc) � <br /> s <br /> Building Contractor: ✓ F Sewer Installer: N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o z O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 0 <br /> m <br /> QQ mEET i L semicks a0 <br /> Cr <br /> 2O n7or m SE usED Fog, [fU►uAev H43174T10N. y <br /> a Fee Rec:� <br /> ° Check#: 9/23 <br /> r <br /> m <br /> n <br /> m <br /> Date of staff site visit: (.jz3/Z5 Initials of site visit staff: {)$ <br /> 2 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: (o/25Lz07-S cn m w <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF C" (tirl <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c� <br /> �1 l� <br /> Page 1 of 5 u u u <br /> Burnett County, WI Land Use Application —Rev 11/2024 <br />