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LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> Applicant Complete All Sections Below This Line to <br /> Permit Types and FeesfPlease,check appropriate boxes) a <br /> Dwellin /Princi al Structure ° 'N <br /> g p $300 Addition/Alteration to Dwelling/Principal Structure $200 c, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> 2 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 1 jWl State Statute 59.692(Sv)Structures $350 <br /> Filling/Grading $150 Boathouse $S00 1 <br /> Solar Panels(Stand alone or roof mounted) $150 1 jPermit 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. 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. z �}- <br /> 0 <br /> Property Owners Name: .I ^ 4 1 S <br /> Property Owner's Mailing Address: S LJr`���T+v' .f` 12 <br /> G State Zip <br /> Property Site Address: C �'t`` � •S %� <br /> Contact's Telephone Number: <br /> d <br /> 7 <br /> Contact's Email: <br /> **If staff has a question4bouthbis application,yod will be contacted via email. Make sure your email address is N o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov S 04 s <br /> Legal Description of Property: PC L N 0 5 C o <br /> Section#:-7, _Town#: 3 Cl N Range#:�W Town of. A ileeg,161 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> ,. <br /> Tax ID#(1-5 digit number,found on tax statement): 1 Z©Z Q <br /> d <br /> Proposed Use of Structure/Addition: hrrP ' E:oy%t a,t yi e-rN <br /> i <br /> Anticipated Start Date: M c T (� z C Z f2_ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � 0 <br /> � EN <br /> Building Contractor: Sewer Installer: N I 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 /> (� Shed old cuu�c Co✓�Aar C"nO be Zed -Foy h ma-yl l�i-� �a-► <br /> 010-rP 30 * bt M\/P-8`(e.L0C(kkJ -110 W1•t,+ jlb�{' S i v,'t %-C-+ rAJ I '6 `J � Fee Rec:300.IV <br /> a Mocl -Red p[off p lu v I,D f✓cL*i an Check#: 130 <br /> Date of staff site visit: S �Z5 Initials of site visit st > Q.cn �1 <br /> ��qq a <br /> c <br /> APPROVED BY LAND SERVICES OFFICIAL-�4 DATE:S (Q 5 <.3 <br /> m `� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> Z F� C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 9 � <br /> Page 1 of 5 S—� <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />