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LAND USE PERMIT APPLICATION — Burnett County, WI ci <br /> 2 <br /> a. � ro <br /> Applicant Complete All Sections Below This Line ; to <br /> Permit Types and Fees�Please,check appropriate boxes) n <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 m <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 tfJ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Imo^ <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 a <br /> Solar Panels(Stand alone or roof mounted) $150 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 /> b <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. o 7\- <br /> o <br /> Property Owner's Name: AEltaN +KK I T4 l! 1) h rtkbicUzi <br /> Property Owner's Mailing Address: QV C I v 7 �t✓� ��i /l�l 1�C7(� (& <br /> � I � City rotate Zip ° � <br /> Property Site Address: .> I�� �N rJ�!- KnA 17 _ �tiU� I �� )5G' < p <br /> o = n� <br /> Contact's Telephone Number: <br /> Z � <br /> Contact's Email: t/(k I , litorIDALtJ "`miu I • W of CD <br /> **If staff has a question about this applica—tionjou will be contacted via email. Make sure your email address is N a <br /> legible and your email provider will accept emails from the following addres_s:/@BurnettCountyWl.gov °0 <br /> Legal Description of Property: (N(g Ki D( at e D I V �o of <br /> Section#: (�}5 Town#: l U N Range#: 14 W Town of: 5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Cn <br /> p w <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> d <br /> Proposed Use of Structure/Addition: C� <br /> Anticipated Start Date: 5 em— ( 0 7a ?) (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ', z <br /> THIS PERMIT 1S SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Di K4GeT ALL 5er9P700' <br /> ZO Nor tt� i3E USED FoR HU�+'t� /�9f3/f�Tlo�./ <br /> ® 5EPnc rgivK Up Ta 8E S�cvA,ED By 9�/Qo2?. �SCR�wS� CD <br /> Fee Rec: <br /> Check#: <br /> Date of staff site visit: 61'�o Initials of site visit staff: ��(1 <br /> Zo2 5CD <br /> APPROVED BY LAND SERVICES OFFICIAL: t t DATE: �3I m CO ice' <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTCD <br /> Page 1 of 5 ltl <br /> Burnett County, WI Land Use Application—Rev 11/2024 �� <br />