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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> a � <br /> Applicant Complete All Sections Below This Line ' N <br /> Permit Types and FeestPlease,check appropriate boxes); ° <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200CD <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 ~N <br /> M U` <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < �0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)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 <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. <br /> z <br /> 0 <br /> Property Owner's Name: 77T ' OT o <br /> o <br /> b I <br /> Property Owner's Mailing Address: U'� <br /> City State Zip IV <br /> Property Site Address: Y✓� <br /> 7 2 <br /> Contact's Telephone Number: 3'2 N Z "Z 7 <br /> Contact's Email: t�Q�(�Ll� �] (�.' 7 ►akw►u <br /> **If staff has a question about thidapplication,yo 1 be contacted via email. Make sure your email address is N ro J <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov <br /> Legal Description of Property: vo2 SuY�l�� t x v w o <br /> fA <br /> Section#: ZU Town#: �l N Range#:�_W Town of- SU j SS ,0 �j, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* v <br /> Tax ID#(1-5 digit number;found on tax statement): '2j <br /> Proposed Use of Structure/Addition: . <br /> Anticipated Start Date: J (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> .0 <br /> Building Contractor: Sewer Installer: y E w <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m z N -f <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z N N <br /> 0 <br /> Di n e ET Au- SC1-8AC -- <br /> A.)or To exceet> Z i3EpReortns lam-R sAN—Z 5 - 13z. <br /> Fee Rec: <br /> °z Check#: I r 9 <br /> r <br /> -G <br /> Date of staff site visit: 7/fZ5 r 712I 12 ' Initials of site visit staff: (r� d' Db a <br /> C <br /> 1 � <br /> APPROVED BY LAND SERVICES OFFICIAL: ) DATE: 7 Lli'Zo25- <br /> _ <br /> UPON APPROVAL: APPLIC T MUST POST COPY OF <br /> PERMIT APPLICATION IN PLAIN SIGHT <br /> SIGNED tC—in] <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />