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c � r <br /> LAND USE PERMIT APPLICATION—Burnett County,WI d <br /> C � <br /> Applicant Complete All Sections Below This Line N <br /> Permit Types and FeesiPlease,check appropriate boxes) a <br /> m <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Itz <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> 9 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 c <br /> Filling/Grading $150 1 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) Isloo . <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. 1° <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S <br /> 0 <br /> Property Owner's Nam , - r C._ <br /> Property Owner's Mailing Address: l �' h E. <br /> C'ty State Z' -J <br /> Property Site Address: i Y1 P �+ i Z . <br /> o <br /> Contact's Telephone Number: �� `� O 1 <br /> 4 r n \ <br /> Q Contact's Email: \�� �' ��f t��f�� LQ lr✓) �% <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 94 <br /> ((�1 legible and your email provider will accept emails from the following address:@BurnettCountyWI.gov 2. J <br /> Legal Description of Property: ^E. 'V ��C S ��(J�S b `t \YS <br /> N <br /> Section#: 3(,o Town#: 0 N Range#:_ W Town of U.i'bl DY1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): Z,E (A 63 <br /> Proposed Use of Structure/Ad ition: S ,v✓►� y N <br /> Anticipated Start Date: � s (Home/Cabin;Commercial Business;Bedroom;Deck,-etc.) 1 � LA <br /> tt55 C— .0 <br /> Building Contractor: ud 'c 4 '5 Sewer Installer: - tom r K� ,15 0 � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Nfe4 a,g k4kcb < — <br /> Q Dwu�njr,D4---b UW-4 Z WrMMS pe.,- Ste►-19-2-7 rA <br /> Fee Rec: 2 Vol00 <br /> °z Check#: g <br /> K <br /> Date of stag site-!sit: ZUZS Ini ' Is of site 'sit staff: r- , <br /> APPROVED BY LAND SERVICES OFFICIA�Za Ile DATE: i 25 25 C )> f a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ro <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 <br /> � c <br /> 0-1c N <br /> Page 1 of 5 3CD <br /> Burnett Countv.WI Land Use Anialication—Rev 11/2024 �� <br /> �� <br />