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r <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line c (n <br /> a <br /> Permit Types and Fees�Please,check appropriate boxes), <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 O <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 9 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: o <br /> Property Owner's Mailing Address: S � <br /> City State Zip <br /> Property Site Address:;+k—KZ 6 Pe,otnt; .f L <br /> y <br /> CD <br /> r•7 C <br /> Contact's Telephone Number: " <br /> Contact's Email: c� 13, C� <br /> **If staff has a question ab ut this application,you will be contacted via email. Make sure your email address is ro <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov E. w <br /> Legal Description of Property: d o <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> � d <br /> Proposed Use of Structure/Addition: -b G"A L' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> p x � m <br /> Building Contractor: Sewer Installer: y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m o .p <br /> z <br /> v <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Z N <br /> Oj ME-6T 75 Fc5d'I- GAOt/VAR4 t'!IG'rt WATCRV�.AAR6C wvw), m <br /> O gDP1T(oN �ITJ 37QVC,rV 6E '5U01 rA <br /> 'C1- ?('$ SEC. 30-!off rA <br /> -tee�v TfoA0 J�'C V Fee Rec: ��� <br /> j7WELL tNf� 1 f /�/OOl)-COA.Ir-b &tk'/V F 6 3 �o oT m <br /> � Lo Uc f C_44t� oCheck <br /> 5EPTlC Ti" LIDf 'M $E SE" #: <br /> z <br /> -C <br /> a <br /> v m __--'a=-� <br /> Date of staff site visit: q1812.5 Initials of site visit staff: <br /> ro N n V V <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:,//&/xCD <br /> en <br /> T < <br /> r.s <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 00 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> ro <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />