Laserfiche WebLink
, LAND USE PERMIT APPLICATION - Burnett County, WI a g <br /> Applicant Complete All Sections Below This Line o c v7. Ni <br /> Z CD <br /> PP P , <br /> Permit Types and FeesPlease,check appropriate boxes) a.lease, <br /> C7 y <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Cpmmercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Q O <br /> i/f 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 °e° <br /> Driveways/&Campground Structures \y pg $125 WI State Statute 59.692(ly)Structures $350 r.. <br /> o <br /> Filling/Grading $150 Boathouse $500 <br /> A <br /> AD <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. o <br /> ., <br /> Property yOwner's Name: yr Tl d. �` 15 /1 G A 1 a <br /> (IS <br /> 0. <br /> Property Owner's Mailing Address: PO ( o X 2 4/9 Pcvti tt inJX S y8 3 . w <br /> _ City I State Zip <br /> Property Site Address: Z 40 yy7 G_ vsc 3 t:-.c./ce a . k y <br /> Contact's Telephone Number: , (3' 7 4/3 8 622, f/ o CI ° <br /> t7 <br /> d`, <br /> Contact's Email: Pe, ir`r l n R e ti d e tN U F 6-M A.r 4.. ,. Cell a <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 a4 <br /> cto <br /> Legal Description of Property: W t y g <br /> Section#: /3 Town#: D N Range#: /7 W Town of: lam//4 tpt/f 5. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> e' o <br /> Tax ID#(1-5 digit number; found on tax statement): 2. y 70 Z_ t w : <br /> Proposed Use of Structure/Addition: (ri rl -C /SW 4:7—! <br /> Anticipated Start Date: --a 9— a. 5 ( ome/Cabin;Commercial Business;Bedroom;Deck;etc.) N <br /> x <br /> Building Contractor: a 4:, 6 J 1 DCO t $ Sewer Installer: its' t. -' m' v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDIT ONS ONLY m S <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o x <br /> 71" <br /> 0/0of ke uses! {ter %uka &h'4724, - <br /> fr, <br /> Mte{ 4/l S Zot,A5 l/4 du 4'it al- /eo S7L /D C/ w+ /ValY- m <br /> / <br /> i", //Nei Fee Rec: 5. <br /> °z Check#: too/ <br /> r <br /> -C tt <br /> Date of staff site visit:9(25125 Initials o ite visit aff: ' ' , NO <br /> 0 <br /> 4.j.1 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: E: /e/6/74Z5--- ` <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF 0_ ,� CI <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 2 Cry <br /> Pagelof5 U.L <br /> Burnett County, WI Land Use Application-Rev 07/2025 <br />