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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a b <br /> Applicant Complete All Sections Below This Line c to <br /> Permit Types and Fees�P/ease,check appropriate boxes), 27 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 vPQ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> M <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 lBoathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 1 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> XrT- <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. r <br /> z <br /> o � <br /> Property Owner's Name: �►� 1'L►A rt"�r =' Z <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> Property Site Address: <br /> Contact's Telephone Number: -7 is— '-s-Y-Tc7 D <br /> Contact's Email: ) �'1 h Ci Gl r-G�� � �� ► =% <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address isIV <br /> N ro <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov d0 <br /> Legal Description of Property: ze ,� ��� 1 5 u d <br /> Section#: _Town#: 34? N Range#:---[-T—W Town of: Plo ote ks <br /> i <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* CODA N o <br /> Tax ID#(1-5 digit number; found on tax statement): �j t 7-7 <br /> � C7 <br /> Proposed Use of Structure/Addakion: ew) fp�'�u- <br /> Anticipated Start Date: -O ome/Cabi Commercial Business;Bedroom;Deck;etc.) <br /> tN <br /> Building Contractor: "�� Y.t�-S Sewer Installer: /'h,/-,e �( 5 itD�Nl W QO Z N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 0 <br /> O WCE- ALL 3ET-.9AC1(5 1 <br /> © i cuw� .ver ?a excEeD Z 8k, FEA -Z9'J—/9- 80 4- y CC <br /> y G <br /> ® FOLLOW 1 wN'E Aal tou,i SuAGACE vul ri&4-Mcn! 19&ACEWE/L"r Fee Rec: <br /> °z Check#: oZ f(o`,- <br /> r <br /> a <br /> M <br /> v <br /> Date of staff site visit: 711r/25 Initials of site visit staff: Og <br /> b C= <br /> z <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> N n o <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' (� <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 11/2024 <br />