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LAND USE PERMIT APPLICATION — Burnett County, WI `� r <br /> a � b <br /> N N <br /> Applicant Complete All Sections Below This Line ° 2. N <br /> Permit Types and Fees�Please,check appropriate boxes) a T_ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0^ Q <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 /> C) <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 /> wJOT- <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> iv <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 /> Property Owner's Name: 1�z.4,i [ lk��� P l l� ►i��n �i�Y����1 0 <br /> Property Owner's Mailing Address: 17c� VYII,,-) ` '1 v• N n <br /> City Statef Zip <br /> Property Site Address: <br /> � o � <br /> Contact's Telephone Number:(:�l ks:i) <br /> d <br /> Contact's Email: Ca-W k� Cbns5 c� ,V,2� a��h1C�► �'b rY) <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N J <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov ° w .p <br /> 5' <br /> Legal Description of Property: L-.u+ -_�) 0_5N V (,1.a_�1 `,��-�E;� �t>� 1)4-3t u 15q <br /> Section#: _Town#:�_N Range#:�_W Town of: L CCr1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* y <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): d <br /> Proposed Use of Structure/Additi n: 1 i Ml e bid <br /> Anticipated Start Date: ►J ome/Cabin;Commercial Business;Bedroom;Deck;etc.) r 1 <br /> �;11 <br /> BuildingContractor: 6 �`; l�C_. Nut Sewer Installer: _ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> 1THIS PERMIT/IS SUBJECT TO ALL CONDITIONS LISTED BELOW: > z b � <br /> �No/ �D exc�Cd S f� S01 i,.`�,# S,4AI /Z�r \ <br /> (29, /1�Of �n eXt eed o► L+e,t y�nf e r �� 1Cf; <br /> � Cou�aGT U�LHS�ecl�✓ T+�/" ,tGf�1 Pe1'tM// . FeeRec: <br /> Check#:,;/ T/ <br /> d r <br /> Date of staff site visit: 9 z3 L f Initials of site visit staff: a.�T L.B � cry <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ` -CD <br /> 3 �v <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF 0_ �' 2 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 07/2025 �� <br />