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1- <br /> LAND USE PERMIT APPLICATION—Burnett County a <br /> _ N <br /> � <br /> Applicant Complete All Sections Below This Line '' -. a k) <br /> Permit Types and Fees(Pleose,check appropriate boxes) •I <br /> i v l <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/PrincipalStrurture $200 i� (V <br /> `^Commercial/Industrial Structure ~$300 Addition/Alteration to Commercial/Industrial Structure $200 !(/I �. <br /> Accessory Structure(Garage,Shed,etc.) _ $150 xcAdditio/Alteration t• • - •• ure $150 j �. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c ,0ifI — $250 QDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse .I ��r—Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $3505• 9\ <br /> Filling/Grading $150 Boathouse- <br /> $500 m <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ^\ <br /> $ E. <br /> "NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. I " <br /> `Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. g <br /> 'items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> V ERAg55 ...IA' o <br /> e ,. <br /> Property Owner's Name: � <br /> S(�C <br /> roperty Owner's?tfei'#tng Address: k ,t . _ <br /> . b , . C .. - e �% b C <br /> n N <br /> M_ 1,wilt City Sta e Zip N <br /> roper, tySree p <br /> AAidress: a• taY 1 rJ 'Di4tJiIlAP.+yl Ll).'r . <br /> o c <br /> Contact's Telephone Number: 1(5" �q7' a�4�7 c <br /> 0 <br /> Contact's Email: NiehlvktS•-VI ••�htR,, .1i 0wergs • tom <br /> **If staff has a question about this applibdtion,ybu will l e contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWl.gov S. o J <br /> Legal Description of Property: t? <br /> Section#: 35 Town#: u 1 N Range#: ) f W Town of: 3t,50I,i5 ii. N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* N <br /> •� '1.mil •' <br /> Tax ID#(1-5 digit number;found on tax statement): 63 et 9D 2.5%.6)— e 3 00 N 3 <br /> V' c <br /> Proposed Use of Structure/Addition: S rtT�Q� q.t. lAt.Ai C N <br /> Anticipated Start Date: �1p III a ba•S Tome/Cabin;Commercial usiness;Bedroom;Deck:etc.) Iv <br /> l <br /> Building Contractor: a{y h7e,tZ Sewer Installer: y -C LAC <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: > z <br /> tv Pc <br /> NW al se-E bobs A <br /> 5- i <br /> tr <br /> 0 Nod 40 bc- used --or tiu mr \r4b4o.--k►co ► > , <br /> Fee Rec1 sue Seri c —rayl d -�-o b e se c ur�d +-I- a o cal �'n b y Check#: <br /> t ! <br /> Lc <br /> 12/3j/024. ;74 <br /> a- � <br /> 5 <br /> Date of staff site visit: II I ZS �L �--� �--� <br /> I !� Initials of si visit staff: r w ; A r- <br /> ��on GGAPPROVED BY LAND SERVICES OFFICIAL'�IQ j DATE: 1i 2Z �-J ; b m 011 , .UPON APPROVAL: APPLICANT MUST POST COPY OFSIGNED PERMIT APPLICATION IN PLAIN SIGHT .a ►� Ilifil <br /> C' <br /> t2 <br /> Page 1 of 5 g "' <br /> co <br /> Burnett County,WI Land Use Application—Rev 07/2025 = <br /> � —�_� <br /> � JJ <br />