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LAND USE PERMIT APPLICATION — Burnett County, WI b r <br /> Applicant Complete All Sections Below This Line ry cn <br /> Permit Types and FeesfPlease,check appropriate boxes) a <br /> 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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °e \ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> `NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> b <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. ; <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ° z <br /> Property Owner's Name: I'Yl iq?-V.$ KA1S <br /> o � <br /> ' .9 <br /> Property Owner's Mailing Address: t 17,�j� Ilo3� S�, k,. r✓-a�['Vi)I E M11v SSOLI-I v <br /> A City State Zip , <br /> Property Site Address: �k j a 11 IFv.4 M bcavt byf V LQ S y R-3© o f <br /> Contact's Telephone Number: �21 �� [o)- O a-30 <br /> Contact's Email: m-T--r U c-K -yo a <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b tJ <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov ° I"4 <br /> Legal Description of Property: PC(L &)Lr) <br /> Section#: l ;R __Town#. q 0 N Range#: W Town of: � <br /> *Attach additional page i/needecl for length•description OR attach a copy of the deed OR attach tay si=stem properti,page. <br /> Tax ID# (1-5 digit number; found on tax statement): <br /> Proposed Use of Structure/Addition: s4olr,tqy-o <br /> Anticipated Start Date: S(��i�y/SurNvn2l` (Howe.'Cabin:ConnnercialBusiness:Bedroom'Deck;etc.) <br /> � � N <br /> Building Contractor: l(�D_ Sewer Installer: d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <br /> ! <br /> D � �� <br /> ©Nod- 6e W -Fo✓ hwrWa� <br /> a <br /> G. YPe � �I I � � � Fee Rec:�_ <br /> @h11cw reS�l'IL-�I( 1S M I'�l�Gt-f I tYI t t ° Check#: 3 / <br /> Date of staff site visit:Z/2�25 Initials of site visit staff: Lp �- KG ( CL <br /> 07 co m Mn <br /> APPROVED BY LAND SERVICES OFFICIA DATE: Z ZS <br /> CD <br /> c� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF R. S <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT M <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />