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LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line o c t <br /> Permit Types and Fees�Please,check appropriate boxes) n <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 \Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 voQ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> V+ <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 /> J� <br /> Filling/Grading $150 Boathouse $500 o <br /> Solar Panels(Stand alone or roof mounted) $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 /> *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. rAll 1 <br /> z <br /> 0 <br /> Property Owner's Name: �7 t- ��t <br /> Property Owner's Mailing Address: <br /> ity State Zip ° j <br /> Property Site Address: i ,ram({_ <br /> O_ C <br /> Contact's Telephone Number: (Z�-p-7 D S~�L721 <br /> N ° " <br /> Contact's Email: -� <br /> **If staff has a question about this application, ou 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: @BumettCountyWI.gov uo <br /> //�� l ,� 4N <br /> Legal Description of Property: L-0+2.1.���� ) S <br /> Section#: _Town#:�_N Range#:(_W Town of: t it.�S S <br /> *Attach additional page if needed for 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): 3�acl( ( .70 <br /> Proposed Use of Structure/Addition: Oc.S e \ 1 I vt!, N -� <br /> Anticipated Start Date: t 0 �(F��� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: % Sewer Installer: hlflP �t n y O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z <br /> /D Sar;4�t/a Wr//ye.�/s1yM�S Aif sS M us,-k d e 5 tf4raA-W 0;4 1 IC� ro e�/7� <br /> arN 5 � <br /> a mDv1 1 5tfQra�/sn/ �(z14Yq. ?M o <br /> \ <br /> D tW Pi e-►^. > cb <br /> Fee Rec:30)�" <br /> /lof >'evo�•�o�-�Z p coP� u" s/��U -ZO—2�19, Z Check#: <br /> 3 EVI- <br /> .571'4— aa/a�re.SS 7b be odA4tKe�✓ <br /> prl�vewotJ T� me-r-f- ciccweal tie��Aflofl ✓ $/)/Z�ZCP, <br /> v w <br /> Date of staff site visit: $ l Z Zs Initi s of site visi aff: Li 8� a a W C <br /> ' � <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: wo <br /> r— <br /> m � w <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF N o <br /> � � C Q+ � N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page I of 5 <br /> Burnett County, WI Land Use Application—Rev 07/2025 <br />