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LAND USE PERMIT APPLICATION —Burnett County, WI acl <br /> Applicant Complete All Sections Below This Line ' N <br /> Permit Types and Fees�Please,check appropriate boxes); <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> A <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 � W 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 % W <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 J <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 O o <br /> Filling/Grading $150 Boathouse $500 F' <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. <br /> z <br /> 0 <br /> Property Owner's Name: re-',pi• A 1 0&- 4;A -1 ? 'o C � <br /> 0 <br /> Property Owner's Mailing Address: y �>b ff �i U fr�f � �ior, -r4 SVv,J <br /> City State Zip <br /> Property Site Address: o y <br /> c <br /> Contact's Telephone Number: <br /> C7 <br /> Contact's Email: f-e CD <br /> **If staff has a que on ab ut this application,you Al be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov <br /> Legal Description of Property:Lod 3 Razz K 1� �Ao�t o yi/do., 14ke o <br /> Section#: Town#: Range#: o W Town of:N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* v� <br /> o � <br /> Tax ID#(1-5 digit number; found on tax statement): I y S 2 S <br /> 1 � d <br /> Proposed Use of Structure/Addition: S-"c� -P,q a <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 °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o s <br /> / Ln <br /> O /Vol- 7p b� Used �pr 11Uov► �uj%�a�ioi'1 . 0` <br /> LDca T�>✓► ?D O� A�u S 7`�a' r 5 e e c� 7�7�a�l�c CY Q-c.�n a►1/• N � <br /> L / / 1 <br /> Ne 71p P�J�'C�.e q 14V� f1 T O 1C �d 1—/• Fee Rec: <br /> �bQ- D Al/N 11— �0/)l z° Check#:oZ aZ <br /> r <br /> Date of staff site visit: gz)Z/20 ZS Initials of site visi ff: T/Lr A I,* <br /> p7 c � <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: S /3 ZD L S'� < ; <br /> M = o if <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF Do <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />