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4-- 4AA& 01/ <br /> U C C r <br /> LAND USE PERMIT APPLICATION—Burnett County, WI <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees�Please,check appropriate boxes) `y <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 5y <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 s <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $1501 0 C —Q'� <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <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. C o <br /> c <br /> Property Owner's Name: 5('e �, C^—%NA ?4Q*e 4z c � <br /> b y03 <br /> Property Owner's Mailing Address: D 41 <br /> / City State Zip <br /> Property Site Address: 3 0/,o 5 ✓ i' ,L D,a Al bu A . �/� SY �/fr n < N <br /> Contact's Telephone Number: 7 <br /> Contact's Email: �'- P"01�0-6.4,t Ts.� 1�/ � ,. : / • c.�--- <br /> **If staff has a question about this application,you will b 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 YQ <br /> Legal Description of Property: 7 y 11 <br /> i ���� N/ � � d A11 <br /> lJr Ur 5. <br /> Section#: o Town#:T44_N Range#: �C/' 1 W Town of: Tf <br /> *Attach additional page if needed for lengthy description OR attac�hya copy of the deed OR attach tax system property page.* <br /> k <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> ' v <br /> Proposed Use of Structure/Addition: 0!/.4t P <br /> Anticipated Start Date: &tA (Home✓Cabm;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: :A ✓4t �i►v1 S:- Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> A' THILLS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z `VJ <br /> /I14lM4N I�14b��aj170r/I V <br /> n� <br /> Fee Rec:� Q� <br /> Check#: � <br /> 2 <br /> tv _J Q <br /> Q <br /> Date of staff site visit: ZO Zo Z� Initi f site isit staff• L/O� <br /> a <br /> CD M <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: C° <br /> r- <br /> Ch <br /> m r.a <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 'S <br /> CD <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 07/2025 U': <br />