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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> < b <br /> Applicant Complete All Sections Below This Line u <br /> Permit Types and FeesfPlease,check appropriate boxes) d '� <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 /> L7 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r" <br /> Filling/Grading $150 Boathouse $500 o <br /> CIO' <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 R. <br /> E <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> CD <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,s as pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: / j n c -0 N <br /> Property Owner's Mailing Address: �-f " 1,�2 17 r <br /> !! A Q ( City �t t Zip <br /> Property Site Address: �U )G' 0,,y-'�� l J �' ll�%1' / '/ S �'�� Z o y <br /> Contact's Telephone Number: L <br /> Contact's Email: -br 1' L✓ I C ' !I l �' �'`7� <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @Burne untyWI.gov �. w <br /> Legal Descri tion of Property: L N <br /> Section#:��Town#: '� _N Range#: W Town of: L'��O�1 �' h <br /> *Attach additional page if needed.for lengthy description OR atta6CP. Pyt <br /> the deed OR attach tax system property page.* -V <br /> Tax ID#(1-5 digit number;found on tax statement): 4 o d <br /> Proposed Use of Structure/Addition: -s <br /> Anticipated Start Date: xome/Ca in;Commercial Business; drop be k;etc rz <br /> OZV <br /> Building Contractor:A 1 " W )Sewer Installer: �l / � Q n 6, <br /> AREA BELOW THIS LINE FOR LAND SERVICES,STAFF COMMENTS/CONDITIONS ONLY r z e <br /> THIS PERMIT IS SUBJECT TO Aft CONDITIONS LISTED BELOW: o X <br /> CIO <br /> O W1ECt ALL TETQ#C-J1$, < W <br /> 2U' ( WGLL1A)C+- A10T -M EtKCEA Z $E-1)ROOMS PfR <54A,-25- Zc{ . <br /> © APPI�I Fop_ APDiQcSS 8y S�IS/zo�S, <br /> Fee Rec! o <br /> °z Check#: <br /> r <br /> z <br /> m <br /> w <br /> Date of staff site visit:qlN/Z5 Initials of site visit staff:'DQCn co <br /> APPROVED BY LAND SERVICES OFFICIAL: ! DATE: <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF o 09,1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Crtr <br /> Page 1 of 5 �. <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />