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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> a � <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and FeestPlease,check appropriate boxes) 1 ° <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 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150p <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> r <br /> Filling/Grading $150 Boathouse $500 % 0 <br /> w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) 71�- <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. r <br /> z <br /> ° <br /> Property Owner's Name: jit}1 !I �/"S CHhFi r o <br /> Property Owner's Mailing Address: as I Lu r-5 1- NF A 11/(�,GL/�'*f =v <br /> City State Zip ° <br /> Property Site Address: <br /> o c <br /> Contact's Telephone Number: Zlk Z,U-0491- ° <br /> v <br /> w <br /> Contact's Email: <br /> **If staff has a question about this application,you 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 `O <br /> 5" <br /> Legal Description of Property: LAA keS W O6A LbT 26 d <br /> Section#: 69 Town#:_L[D _N Range#:___Y� _W Town of:J(04 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Ida J <br /> Tax ID#(1-5 digit number;found on tax statement): f <br /> DeuL ° <br /> Proposed Use of Structure/Addition: W <br /> Anticipated Start Date: H ZQZ�j ( ome/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> z <br /> Building Contractor: to � �fSY1�Ir GCL hN5 Sewer Installer: 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: o <br /> m <br /> a <br /> n <br /> m <br /> Fee Rec: S 0 6) <br /> ° <br /> z Check#: C la.�, <br /> r- <br /> < <br /> a <br /> v v tn�,f <br /> o � l Uou <br /> Date of staff site visit:_ o Z� Initials of s' a visit st / G� 3 (a) C <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: Z(o ZO Z� a <br /> CD - <br /> D to o O <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF Q <br /> N <br /> N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ffR <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 07/2025 <br />