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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This LineCD <br /> Permit Types and FeestPlease,check appropriate boxes) a , <br /> b <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 /> CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk I IBunkhouse $250 <br /> Driveways/&Campground Structures $125 1 jW1 State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 IPermit Extension(1 Year Extension-Allowed Once) $100 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. <br /> z <br /> 0 <br /> Property Owner's Name: o1, t5c, <br /> 0 <br /> 0 <br /> a <br /> Property Owner's Mailing Address: y(Py� ALI T CN • c_5 /0y 5-5-Y0i, R. <br /> City State Zip <br /> Property Site Address:_ZPy 03 6104;c (/I/i'ask- (�.i 37 5-Lib 9; <br /> CD <br /> o c <br /> Contact's Telephone Number: �7 15"- 5 C, r "Z 1 7 fj Q. <br /> d <br /> Contact's Email: bn.2leXcrr-tczA2encn 42_L , •roe <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov o� <br /> n 5' <br /> Legal Description of Property: 1 CL. C' CCU L'� 3 �}ese GUS� 7-31 d <br /> Section#: Ob Town#: L/0 N Range#: /ti W Town of: 5Lo f+ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): 1-?7 5-6 � <br /> � � d <br /> Proposed Use of Structure/Addition: .} i mot.-- �1 <br /> y <br /> Anticipated Start Date: A,,,j 15— (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> a <br /> Building Contractor: 13 raA A^2-c ge r. Sewer Installer: <br /> V <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS//LISTED BELOW: zLA <br /> O� <br /> �/Q0 _ -IV I'e u5eo' 17e�r AUV-4ah l7o�Di�a1`io� , <br /> �CoN�vll1� S�jol•� /7 /s a�oV-e- -HAe- 1112i-0041q/iNo y <br /> Fee Rec:15 <br /> c) Check#: 51 D� <br /> d <br /> Date of staff site visit: 7�2�/ 20Z S� Initials of 'te visit ff: �� m C ^ <br /> 3 �O <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: R � w y w o <br /> 0o <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF <br /> 3 ` Ln <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r�u!i <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 07/2025 <br />