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Ln <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a z <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and FeestPlease,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 C/ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 1 lBoathouse $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 /> *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: <br /> (�.y a W <br /> Property Owner's Mailing Address: 22(0 D <br /> City State Zip <br /> Property Site Address: aa- pit>5 3 �'2R�►J 1�+'-�- �'f 4 '1 f.- o N <br /> c <br /> Contact's Telephone Number: 7 j -C-3 -L)69H fCD <br /> a <br /> Contact's Email: "tZ' SteEZ L 9y /kA,.eOM <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °0 W <br /> , O <br /> Legal Description of Property: S L L, TF 3 00 A S''vj d <br /> '/� <br /> Section#: �T Town#: N Range#:_J-7_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 /> U-4 g <br /> Tax ID#(1-5 digit number; found on tax statement): -L C7 <br /> Proposed Use of Structure/Addition: fAf, � �cat Dl� ,*Alhel`tt k c �n n►J oNo <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc) QQ M, N <br /> Building Contractor: S Sewer Installer: <br /> N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: rA <br /> o <br /> OMet-� <br /> ZO <br /> bkc <br /> FtN� 33oa� <br /> Fee Rec: <br /> °z C1�eek-#: 2 curl, �u <br /> m <br /> n <br /> Date of staff site visit:`1 -Z 70Z5 Initials of s' a visit staff:`.(-� C o <br /> ZUZ 7 a <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: <br /> a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 2 ' C� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 00 -� o <br /> 1::� C <br /> Page 1 of 5 � M <br /> Burnett County, WI Land Use Application—Rev 12/2023 <br />