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LAND USE PERMIT APPLICATION—Burnett County,WI r <br /> a � � <br /> N <br /> Applicant Complete All Sections Below-This Line ; un <br /> A. <br /> Permit Types and FeesfP/ease,check appropriate boxes) <br /> O <br /> Owelli,WPrincipal Structure $300 I AdditiorgAkeration to Dwelling/Principal Structure $200 ca „ <br /> Commercial/Industrial Structure $300 Addition/Atteration to Commercial/Industrial Structure $200 \ ?be.T <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Atteration to Accessory Structure $150 <br /> Armory Structure(Comrnerciat/tndustrial) $200 Addition/Aitmatiion to Bunkhouse $150 <br /> �(p DeWStairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(iv)Structures $350 1 <br /> Filling/Grading $150 Boathouse $5W J!r <br /> Solar Panels(Stand alone or roof mounted) $150 IPermit Extension(1 Year Extension-Allowed Once) $100 L !� <br /> w v) <br /> HOM After-the-fact permits(permit acquired after constriction has begun)may cost up to three tines the normal fee. a <br /> -o <br /> *Communicabon Towers,camping Permits&Signs require a different apphcabon farm,see ding oppiwabon,and fees_ <br /> 'Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 97 <br /> z <br /> `� o <br /> Property Owners Name: 1'J N <br /> Property Owner's Mailing AddressAkie i)52, 6/ W III t �� G <br /> it State Zip — <br /> Property Site Address: CD <br /> w <br /> Contact's TelephoUlTiL>fwl <br /> ber FC)/' 1197 'S © <br /> Contact's Email: <br /> **If staff has a question about this application,you wii contacted via email. Make sure your email address is d p <br /> legible and your email provider will kept emads from the following address:(a?BurnettCouotyWLgov W N <br /> � � N <br /> Legal Description of Property: .p N <br /> • o <br /> Section#:d5_Town#: 40 N Range 4:A:771 _W Town of k1ok t <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax sjvem property page_; <br /> I A N X <br /> Tax iv#(1-5 digit number,found on tax statement): n�L o <br /> Proposed Use of Stnxturc P d`�'ri�u► fL lY Qi -� <br /> Anticipated Start Date: {�?j� (HomelCabin;Commercial Bus-,-;Bedroom;Deck;etc.) C <br /> D <br /> Building Contractor. Sewer histaller: O Z <br /> AREA BELOW THIS LINE R LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z <br /> O i►90r 4LL 51FTBAck5 -1 <br /> m <br /> Fee Rec:,6 <br /> cl Check#: Ql t / <br /> mL <br /> Date of staff site visit: 7b 25 Initials of site visit staff: D$ >4APPROVED BY LAND SERVICES OFFICIAL: � L DATE: l 2o25- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFSIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />