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LAND USE PERMIT APPLICATION — Burnett County, WI U <br /> N <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d � <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 CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 '7 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk <br /> Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r, <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ° <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping, etc. a <br /> z <br /> c <br /> Property Owner's Name: -�� � N C et �F'�C•�5�� o <br /> Ich <br /> Property Owner's Mailing Address: 17v3i CvP�-A'( ��� TIC t 14K1- 30 y. J <br /> City State Zip <br /> Property Site Address: W 14 r13 S—Y'M 3 v <br /> o � <br /> Contact's Telephone Number: �S t- Ql�-6CE3 <br /> ii c� b <br /> Contact's Email: O�Gu�I��(P� q lri�t =� Lo✓V` <br /> **If staff has a question abut this applicatio ,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept entails from the following address: @BurnettCountyWI.gov ° one <br /> �o-T � CS K S M-5- vot 30 Pf g,S' =' �. ��-F a BoL g o <br /> Legal Description of Property: � ,2 C <br /> Section#: 3 3 Town#: 141)N Range (e W Town of: <br /> *Attach addiiionalpage rf needed.1or lengthy description OR attach a copy qj the deed OR attach tax systetn property page. <br /> H H <br /> >11 <br /> Tax ID#(1-5 digit number;found on tax statement): 6 W d <br /> Proposed Use of Structure/Addition: r a l 4 SC l2C{-►J �c�e L�� ��'i4�t <br /> Anticipated Start Date: !Ty, --�-$�_ (HomelCabin;Commercial Ruts' ss;Bedroom:Deck;etc. <br /> Building Contractor: 15,C� L F Sewer Installer:—4-1 -- V', e ,J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONtMENTS/CONDITIONS ONLY Re <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> z <br /> Q MST -M Ige- "c-r> FAR gVw*v .4AB1rATi0,V <br /> ® "Cr r r9u-- S r r Bkc.KS ' <br /> a' <br /> Fee Rec: <br /> Check#: <br /> Date of staff site visit:7115- Initials of site visit staff:QQ > <br /> APPROVED BV LAND SERVICES OFFICIAL: DATE: 1 1`f Z0z,5 o <br /> 00 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N o <br /> SIGNET) PERMIT APPLICATION IN PLAID SIGHT <br /> Page I of 5 <br /> Burnett County, WI Land Use Application —Rev 07/2025 <br />