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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> a g <br /> Applicant Complete All Sections Below This Line o w <br /> Permit Types and Fees(Please,check appropriate boxes) d Ca.CD <br /> ,J <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 °� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,.D O <br /> V Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 a :. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> r <br /> Filling/Grading $150 Boathouse $500 <br /> v) r <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 a. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. l <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treoted as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> o <br /> Property Owner's Name: 1! <br /> 0 <br /> 0 <br /> a. <br /> Property Owner's Mailing Address: (0 I E f Nle )JCS- _6 T J-3 w <br /> City State Zip ' <br /> Property Site Address: p�to to d g a.o-� < <br /> Ile <br /> , •o a <br /> Contact's Telephone Number: -7 ( �' b 1 -3 q-. <br /> b <br /> n ( d <br /> Contact's Email: 0(�,k a tu�J o Y l&i,, 0.0 vi \ <br /> **If staff has a questio about this applicati n,you will be contacted via email. Make sure your email address is N <br /> QM <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and <br /> @BurnettCountyWl.gov u <br /> g Descriptionp L 4 Lj C�.S/'1 V o P ??o ñ v'4?s P 117 ° ....1Le al of Pro e 0 <br /> Section#: ID Town#: N Range#: RI- W Town of: <br /> �T�T 1 7:)1 0_ v' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> i5 ) 7 G g 5Tax ID#(1-5 digit number; found on tax statement): ) <br /> Proposed Use of Structure/Addition: & <br /> Anticipated Start Date: ome/Cabin; ommercial Business;Bedroom;Deck;etc.) _ <br /> Building Contractor: eel 1 fei 6-e &CI l r Installer: .0n <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Orifice- et 4/ seFb4 . <br /> wmoil_ ( ( ti,4/114[4 b1 A:66' ' <br /> E7 <br /> ��— <br /> c Check <br /> Rec:#: / <br /> • <br /> .1- Fee rn <br /> z <br /> � EA o ` J <br /> Date of staff site visit:CI l Iq1;3 I 'tials of site v' 't staff: W- x j <br /> Q/ / a <br /> trEI <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ` l�8(?3 m m W C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o <br /> r 0 c N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT X m.`< N <br /> Page 1 of 5 rt wffil <br /> R. <br /> Burnett County,WI Land Use Application—Rev 3/2023 v k. <br /> tn <br /> 3 <br />