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CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line cn <br /> Permit Types and FeestPlease,check appropriate boxes), <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 X <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 /> G) <br /> X IDeck/Stairs/Patio/RetainingWall/Sidewalk 113unkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 1 113oathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 1 jPermit Extension(1 Year Extension-Allowed Once) $100 . <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form,see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name:�'c✓ S -e n �.P =' K <br /> °o <br /> Property Owner's Mailing Address: 7 r p Son 1 -e ---i t is 5-I/k7z w. n <br /> City State Zip <br /> Property Site Address: SGt s,n --e c N <br /> C <br /> Contact's Telephone Number: 6s1 Y9 2 —Z 7 r Z a <br /> C7 <br /> w <br /> Contact's Email: f9 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ro p <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov R. °Q J <br /> as <br /> Legal Description of Property: d <br /> Section#: Town#: N Range#: W Town o£ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: 7 C I <br /> Anticipated Start Date:� (H e/Cabin;Commercial Business;Bedroom; ec etc.) <br /> Building Contractor: Sewer Installer: co <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> m <br /> w1 EST A t_c_ .5E7-B�4fJL,S � <br /> —`4i m <br /> Fee Rec: <br /> z Check <br /> r <br /> -C <br /> r <br /> �2 <br /> Date of staff site visit: Initials Initials of site visit staff:'A$ <br /> r � <br /> APPROVED BY LAND SERVICES OFFICIAL: \ DATE: `I 2 ZoZS T� ` J' <br /> csa <br /> C7 o C� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF K <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT `° <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />