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c.l~u>vu1 l��ve.n cyryov" It <br /> LAND USE PERMIT APPLICATION — Burnett County, WI <br /> s. `b <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and FeestPlease,check appropriate boxes) a <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Nto <br /> Commercial/industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 %N o' <br /> Accessory Structure(Garage hed etc.) $150 Addition/Alteration to Accessory Structure $150 �. <br /> Accessory structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 M <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 S H <br /> Solar Panels(Stand alone or roof mounted) 1$150 1 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 /> *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 r <br /> 0 <br /> Property Owner's Name: T ✓y t es 1 I' S C h S 4 ` <br /> a <br /> Property Owner's Mailing Address: &Of Sy� �. <br /> �7 City State Zip <br /> Property Site Address: lob �� aly rr L—n Ga Syam1 c <br /> Contact's Telephone Number: O <br /> C7 <br /> Contact's Email: 11 i/�� 11 1✓iSQ Yl &Ale I�� e�✓y 1 <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 f Mowing address: @BumettCountyWI.gov o0 <br /> Legal Description of Property: <br /> 3. <br /> Section#:.S l Town#: OW N Range#: W Town of: RUST: <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 14 qd�0 ,I_l I C <br /> Proposed Use of Structure/Addition: Si- fa!' e- Wcde-f �D'4 S ITC �Ac lie 15 <br /> Anticipated Start Date: U4 a Qa (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: S 2�� Sewer Installer: � _ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> A'THIS PERMIT IS SUBJECT TO/ALL CONDITfION,., <br /> LL SS LISTED BELOW: � z <br /> lUO TD be. U s C.a �r A la l"ci✓1 4 10/'/ct 749'9,,4'1. <br /> A <br /> trJ <br /> Fee Rec: A 60 <br /> Check#: CA S M <br /> m <br /> r- <br /> Date of staff site visit: gA&gas— In' 'als of site visit-staff: i a 3 <br /> a c_ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: g 7 ZO ZZ UPONUPON APPROVAL:_APPL CANT MUST POST COPY OF D o w <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3`` C <br /> rt <br /> Page 1 of 5 r--,---� <br /> Burnett County,WI Land Use Application-Rev 07/2025 �� <br />