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Cn <br /> LAND USE PERMIT APPLICATION— Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line to <br /> Permit Types and FeestPlease,check appropriate boxes), <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 /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk I 113unkhouse $250 <br /> Driveways/&Campground Structures $125 1 IWI State Statute 59.692(ly)Structures $350 r" <br /> 0 <br /> Filling/Grading $150 1 113oathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 1 Y jPermit 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 /> b <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: nk-o 7 L— h• �' <br /> °� 00 to <br /> Property Owner's Mailing Address: 'Fr e C.-� `� 1j b14 N w.%cT�4 �o o <br /> City State Zip N <br /> Property Site Address: Z(X 3G:P 7 R L d1�:, b:1 t-- ti S o N <br /> _ CD <br /> c <br /> Contact's Telephone Number: <br /> _ N d <br /> Contact's Email: r",cb-ev.TA e y ' IS <�--C o 7, - N- <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q <br /> i� �'� 2 � d s W <br /> Legal Description of Property: /J o�� (F - <br /> N A <br /> Section#: .Z C:� Town#: y N Range#: W Town of: G <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number; found on tax statement): 3 �2— W o <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc) L <br /> z <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m N <br /> z N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o 1D °p <br /> y <br /> Ir1 <br /> THIS 15 A• PERMAt'- E,,W EC/!5/0,0V TbR L-0P - 7-f - 7-3( ANO n c <br /> W l c-k- EX P I tzf.F O N q- l 43C <br /> Fee Red: o ) - <br /> Q Sgq'r�c- -ranNK- '.-f o -7z.� 3E ,Se cu��t p 3`l G nc�c Uf•�� °z Check#: 7• <br /> 94 G Zo 2.5-. � an <br /> m <br /> Date of staff site visit: 2 3 �Z S Initials of site visit staff: <br /> ro m co 3' IRA <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Z/l`fl zS 3CD <br /> �� N <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF _ o <br /> -0 = <br /> r<ry� <br /> SIGNED PERMIT_ APPLICATION IN PLAIN SIGHT 3 <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />