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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> a <br /> Applicant Complete All Sections Below This Line vNi <br /> Permit Types and Fees fPiease,check appropriate boxes) i:7 a <br /> V <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 K <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 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> or <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) 1$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 /> 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. o <br /> z <br /> 0 <br /> Property Owner's Name: <br /> 0 <br /> o Sys o Rd.Dan u M5� W <br /> Property Owner's Mailing Address: d W <br /> City State Zip <br /> Property Site Address: <br /> 6QrK e-�-7 z o <br /> Contact's Telephone Number: _71 5 l /�� /n�� a <br /> C7 <br /> w <br /> Contact's Email: C om <br /> **If staff has a question about this applicatio u will be contacted via email. Make sure your email address is N v <br /> legible and your email provider will accept emails fro the following address: @BumettCountyWI.gov �. aQ N <br /> w <br /> �`, <br /> Legal Description of Property: U 4 v Y VA' r�, <br /> Section#:- Town#:�N Range#:� �W Town of: �/w�SS �' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 2 N <br /> 70 o <br /> Tax ID#(1-5 digit number;found on tax statement): �f �(0 7 <br /> Proposed Use of Structure/Ad ition: <br /> 6f <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° 6' <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z <br /> v X <br /> d n C r AU s-ergjCwS <br /> G tib r 'ta BE USED Fob— 14V"%4n-) 1j9d t r'ATl oN <br /> Fee Rec: <br /> °z Check#:77/3g <br /> r <br /> z <br /> Date of staff site visit: 9151 Z T Initials of site visit staff: I:B <br /> APPROVED BY LAND SERVICES OFFICIAL: i DATE: -3 r— <br /> CD <br /> N <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> �-- R Page 1 of 5 <br /> Burnett County,WI Land Use Application -Rev 07/2025 <br />