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LAND USE PERMIT APPLICATION—Burnett County, WI Cr <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees�Please,check appropriate boxes) p <br /> C7 <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 $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 jWl State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 lBoathouse $500 N , <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> R. <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. <br /> z <br /> 0 <br /> Property Owner's Name: WkC�� o <br /> 0 <br /> Property Owner's Mailing Address: V cc e 1 <br /> y� } City State Zip <br /> Property Site Address:tuelz ek jjr� � 46iit1/' k L; 5 C o N <br /> _ a <br /> Contact's Telephone Number: le <br /> w <br /> Contact's Email: aya ct m-ey-) 'L Y)- ty4- tI-Lz=&v • rQ0 Y►I <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: @BurnettCountyWI.gov <br /> Legal Description of Property: C � e <br /> Section#: Town#: 'T 0 N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy,of the deed OR attach tar system property page. <br /> Tax ID#(1-5 digit number; found on tax statement):_ ��/ d <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date:-1()14 Zr (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) i _ <br /> T "A <br /> Building Contractor:T yj "Ai-y if�C Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> gl4C/ cACi �o b e iHs /�� �cr L epAL 76k v <br /> Cor� �7� U s�oe��i^ f v See i'F ./ <br /> m <br /> Fee Rec: <br /> °z Check#: ( <br /> r <br /> m <br /> Date of staff site visit: Initials of site visit staff: /, CL <br /> Cn <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Jz 2 co3 CD <br /> 3 <br /> PL CANT MUST POST COPY OF Cn <br /> UPON APPROVAL: AP <br /> -- o 0 . <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> CD <br /> Pagel of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 U <br />