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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line c c <br /> Permit Types and FeestPlease,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `o <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 /> G) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 1 IWI State Statute 59.692(ly)Structures $350 9' ` <br /> Filling/Grading $150 1 lBoathouse $500 N <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. CD <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:io R : ) ,/ Ji o <br /> `3' <br /> Property Owner's Mailing Address: 7 v <br /> City State Zip <br /> Property Site Address: 172. <br /> Contact's Telephone Number: <br /> d <br /> Contact's Email: <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov R. °O N <br /> ao <br /> Legal Description of Property: d <br /> N <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 /> CS W C7 <br /> Tax ID#(1-5 digit number;found on tax statement): `J ��� Nl •� <br /> C7 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ()1 <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o �0 <br /> —ftt►s 1s <br /> I�w�Q,(,i naf tk(eed pe�,- 'SAN# 1(P8(Q1 <br /> a <br /> I Fee Rec: 1(�°_ <br /> I S peon, A 1 � 01✓� �d f 1A/Z�Z�J z Check#: 3 D� <br /> a <br /> m <br /> v <br /> Date of staff site visit: S �5�25 Initials of site visit staff: G 3 <br /> C <br /> APPROVED BY LAND SERVICES OFFICIAL4.� i L�U DATE: �J ZZ �j ao <br /> • APPLICANT MUST POST COPY OF <br /> UPON APPROVAL. APP � 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT P <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 U <br />