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a- - -W <br /> LAND USE PERMIT APPLICATION - urnett County, WI Cr r <br /> Applicant Complete All Sections Below This Line 0 c t <br /> Permit Types and Fees�Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 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 /> P <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 <br /> G\ <br /> cn .� <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 7 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> v <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. c =\ <br /> z @ <br /> Property Owner's Name: .Ae=5gi z e-SS4,r <br /> o <br /> Property Owner's Mailing Address: s I S�1 �..� h 0 C..K.S ("Q.► 4- <br /> City State Zip <br /> Property Site Address: ca.571S 1 '7,r � <br /> o c <br /> Contact's Telephone Number: S01" 3ay <br /> Contact's Email: a.SS; f u n t @ G ryxa.; --t <br /> **If staff has a question about this applicatio W,you will be contacted via email. Make sure your email address is N v <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov a aQ <br /> L'Of4 C M 6201, 01 241 P2-45 96CO eA CtS Dom'-At* - <br /> Legal Description of Property: NE Mi5ll c7 <br /> Section#:_J;k Town#: <br /> --79 N Range#:_L9 W Town of: 4,LO <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): 3� 33� <br /> Proposed Use of Structure/ ddition: (►141 Ir 'jawlV-- V" <br /> Anticipated Start Date: "a�^ oZs (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (� <br /> = W <br /> Building Contractor: Sewer Installer: y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m W <br /> THIS PERMIT IS SUBJECT TO ALL M <br /> CONDITIONS LISTED BELOW: o <br /> o Nv/- 3 d��o s �� s4y, �y spiv-z�_ ��3. <br /> U,i,�, ,4 c ��" T�► - eil J^ ei►^A4 /. LA <br /> v Fee Rec: <br /> °z Check#: e4aSh <br /> r <br /> -C <br /> M <br /> n <br /> m <br /> .� m r <br /> Date of staff site visit: 8 Ini 'al f sit aff: t./t �/�� a a u` <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> o �1 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF o o ' <br /> m c IV <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTco <br /> SDK N <br /> Page I of 5 <br /> Burnett County,WI Land Use Application—Rev 07/2025 <br />