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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line �! <br /> Permit Types and FeesfPlease,check appropriate boxes) N a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 p W <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 , <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 WI State Statute 59.692(ly)Structures $350 r <br /> 0 <br /> Filling/Grading $150 lBoathouse $500 <br /> m. <br /> Solar Panels(Stand alone or roof mounted) $150 1 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> m <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. T r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> 0 <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: 2 3 U NT GT"d C f A 4' S 37 1 <br /> City State Zi <br /> Property Site Address: 7 7 L( 0c)+`.f� s'j' \I�V S"�� -f Cf o N <br /> Contact's Telephone Number: �� 2- , 0 N ° <br /> C7 <br /> Contact's Email: Lb Y�e A V"e4-C � �a.V � � h�� r-}-� � � cc W'\ � <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b O <br /> legible and your email provider will accept emails from the followin address: @BumettCountyWI.gov R. °0 <br /> Legal Description of Property: ��' � k d <br /> Section#: �� Town#:��N Range#: _W Town of: j <br /> *Attach additional page if needed for lengthv description OR attach a copy of the deed OR attach tax system property page. <br /> �O 0 � <br /> Tax ID#(1-5 digit number;found on tax statement): 3 3S-7 Z W <br /> Proposed Use of Structure/Addition: &ce d W t)OX �44 k.- i'\►''4'L 4AC rV-f-e -� W <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: �''�► �- Sewer Installer: �f <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> m <br /> 3 <br /> Fee Rec:_ <br /> °z Check#: <br /> r <br /> -C <br /> z <br /> m <br /> Date of staff site visit: 12,Z,)ZOZ5 Initials of site visit staff- h-r <br /> APPROVED BY LAND SERVICES OFFICIAL. A(�t! � DATE: ZZ �UZS Cn W C <br /> `° r— <br /> < j <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co, <br /> 00CD a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 � 11 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />