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LAND USE PERMIT APPLICATION- Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0 c vi <br /> Permit Types and FeestPlease,check appropriate boxes), a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principalstructure $200 Ni <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �- O <br /> G <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 /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <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 /> *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 /> o _ <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: ` � V ✓) ✓ <br /> City State Zip ° 4 <br /> Property Site Address: o N <br /> Contact's Telephone Number:��� -775 Vo(p a <br /> d <br /> Contact's Email:,51&n n n 6n VA n In 2�2 g l� 641 r y a YYI <br /> **If staff has a question about this appHcation,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: @BumettCountyWI.gov °Q <br /> Legal Description of Prop erty:�a W WWY) k iN '& Y"G 2 P) w+I& d <br /> 3. <br /> Section#:- jf� Town#:__q N Range#:__I(p W Town of. ,-Sly)I,�S <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> �I ° <br /> Tax ID#(1-5 digit number;found on tax statement): Z30 �J <br /> Proposed Use of Structure/Addition: Alr& U\ re lu N OuytWe rdpeK+q -� <br /> Anticipated Start Date: J (Home/Cabin;Commercial B siness;Bedroom;Deck;etc) <br /> Building Contractor: Sewer Installer: O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z . s <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> or X � <br /> A <br /> �Z n or� -to be u.5ed Fpv h kvnwi hala <br /> Fee Rec: 5�•()� <br /> O3 P,*63 6r AaveSS bud 7- 1S-20Z5"• o #: <br /> z 5h <br /> z <br /> M <br /> v � <br /> Date of staff site visit:5� �ZS Initials of site visit staff: pa a <br /> m�• I C <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: LD"jq <br /> m z <br /> a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF cy"Ln <br /> o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />