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LAND USE PERMIT APPLICATION— Burnett County, WI r <br /> a ro <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and FeestP/ease,check appropriate boxes) " c <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 %FCD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 C7 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G <br /> � d <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(Sv)Structures $350 <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 /> 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: G t q I CA cRadkit Z 8 W <br /> Property Owner's Mailing Address:�q L,/� �O w PgG�1 R Sw ��� �✓I SS 3'�' f <br /> City State Zip <br /> Property Site Address: O-Lq yoy Fu4 ul, VC,elf 11416U.-I �/� L� 5V z o N <br /> Contact's Telephone Number: �j(+/yl I C/ '-7 7 y 6-33 1 CD <br /> f b <br /> Contact's Email: rrq l , R A dd'1 t 7-IQ &W161 1 Ivi <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q <br /> 5' <br /> Legal Description of Property: P a� oT R I v l—6"At Ho 4s'j 3 d <br /> Section#: d b Town#: !G N Range#: W Town of: (`jam /� 5 1 Cl <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> e o <br /> Tax ID#(1-5 digit number;found on tax statement): 6(d I W d <br /> Proposed Use of Structure/Addition: a/G 'e y <br /> Anticipated Start Date: J N I J (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: �*'/N �i Sewer Installer: C4 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY d z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: > <br /> Nod- 4-0 be UStJ -Fo,r �� --c '► <br /> _`. ,, g I I IZO25 � Fee Rec:�� <br /> m oe-A � ° Check#: <br /> {j0 nee,-�s ok Lt�.nd Ilse P�rm�+ by $It ��25 <br /> Date of staff site visit: LP -] 2DZS Initials of site visit staff- k-Ca <br /> C <br /> APPROVED BY LAND SERVICES OFFICIALJJ DATE: 2p ZOZS m <br /> ('�,( � c° C n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o �CD <br /> 11�t <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTCD <br /> Page I of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />