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CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a _ b <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and FeestPlease,check appropriate boxes) d <br /> m <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 vo <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 /> M <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 lBoathouse $500 <br /> m <br /> Solar Panels(Stand alone or roof mounted) $1501 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. <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: .rc►-`A,0 KGS(Lzf �jI o <br /> Property Owner's Mailing Address: Z%52. �`I r' L �N 1 8t�t k AW J dCIO <br /> 1 - City State Zip <br /> Property Site Address: 007 �,,�c� {��ol <br /> c <br /> Contact's Telephone Number: <br /> C7 <br /> w <br /> Contact's Email: <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N It <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov 7 00 <br /> 5' <br /> Legal Description of Property: p(-L (,OQ �-GT <br /> Section#: Town#: 1\O 0 N Range#: t 6 W Town of. <br /> *Attach additional page if'needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> O � X <br /> Tax ID#(1-5 digit number;found on tax statement): Z 6 N N d <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: 1/Ib/2S (Home/Cabin;Commercial Business;Bedroom;Deck;etc) C0 <br /> Building Contractor: — Sewer Installer: _y Q <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Q Inee4 qd �e 4-6ac ks. IDom- S,e..- 6&J- -b S A enFe r'+-l - <br /> 2� N o+ -Io be �d -� hw►m.an k.a.�i-��,,�`� y <br /> Fee Rec: � <br /> OSYW r+ :-Te rtn R&,* ,( Li ft✓r&f hjcu Q,1(.�Pi✓?e� 1'�ff6t rt11 ew li' P�oxt, � z Check#: <br /> ru4 2D25, b� g�l �2o2S <br /> d I� <br /> Date of staff site visit: f 3D/�25 I itials of sit visit staff <br /> b a L <br /> APPROVED BY LAND SERVICES OFFICIA DATE:7 8 ZQZS Cn CDa) Z <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> CD a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 <br /> Page 1 of 5 �-,---�—,, <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />