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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> N <br /> Applicant Complete All Sections Below This Line ° vi <br /> a C � <br /> Permit Types and FeesfPlease,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <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 1 jWl State Statute 59.692(1v)Structures $350 C <br /> 0 <br /> Filling/Grading $150 1 lBoathouse $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 /> �o <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. o <br /> z <br /> Property Owner's Name: c T o <br /> Property Owner's Mailing Address• 1 <br /> Property Site Address: I�(��� ��' � J! •��LJItJ/ < <br /> Contact's Telephone Number: -7/-45 - 4-6 � <br /> !�" <br /> Contact's Email:LA)h I t-e,+o ( I )lit 2r r n-,,,0 C-,S h et m I ' - C Ott-) <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 ejuails from the f llowing address:P@BurnettCo nt WI.g v <br /> Kf" dad 4SA��x+e 4-7 I(ol(orsk1a�zl(t SY2 A <br /> Legal Description of Property:. C r 'tom �r Y ► (-c 1 I CS J►C -t� d -4- <br /> ' 1 � <br /> Section#: Town#: L4� ' N Range#: l--_W Town of: F <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): <br /> c w <br /> 36- <br /> Proposed Use of Structure/Addition: t�r(��t� DLUI r(mil 1 ro --3 <br /> Anticipated Start Date: 812 Q 'Z 0-2 one/Cabin;Commercial Bus' ;Bedroom;Deck;etc.) 9 `\ <br /> 7 <br /> Building Contractor: Ova� fl e bt,l_t�C( Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o w <br /> �I FMI OuJ a.0- C(.1.P- 23-I'7 , I�-- <br /> O No+ 4-0 be, u.secl -PDY hLLwV..h ha-la+u�fi01'►. m <br /> r 2g'x�30' l.U,l� <br /> `thts Te rra It'IS't'DY, a S °D a&je lout i l dl t�(#3, b6 h� Fee Rec:+Z, 00I <br /> l 0 U.YI I-ks "4 Mp"SI ova to Sfa�0.9e bu►I d►'�� I aald #!2 (}�� r" Check#� <br /> 25' X Z(p' -eaCh� addIticMaa <br /> 4 u i;i&. A crr,Sc, ��If-9 of 5D <br /> ka,VeIo�P-►� re C,r_e.d • 00 vvtore A•va a.0-61v- <br /> d 0 <br /> Date of staff site visit: 9-Ag-&a5- Initials of site visit staff: w <br /> Q <br /> APPROVED BY LAND SERVICES OFFICIAL:WA�&Stzu*o:�,?—DATE: D <br /> m r- C <br /> .23 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y (� <br /> 00 o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT `° ` <br /> Page 1 of 5 CD <br /> Burnett County,WI Land Use Application-Rev 07/2025 —r---=,—� <br />