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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line cNn <br /> Permit Types and FeestP/ease,check appropriate boxes) ° <br /> C7 <br /> Dwell ing/PrincipaI Structure $300 Addition/Alteration to Dwell ing/PrincipaI Structure $200 o <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 f ~ <br /> G) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r <br /> V• <br /> 1 <br /> Filling/Grading $150 Boathouse $500 0 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 R. <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> Property Owner's Name: <br /> °o N ' <br /> Property Owner's Mailing Address: � 'fie•-• <br /> / City State Zip <br /> Property Site Address: 7 T 1/5l ��P�i / �£ �G <br /> // o c <br /> Contact's Telephone Number: <br /> Contact's Email: y✓���/��Yli�lei7 /�l�fm��r / "� <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 <br /> //will accept emails from the following address: /@B"umettCounttyWI.gov R. <br /> Legal Description of Property:li Z 2 /V/Z G'Z5. <br /> Section#: Town#: yG _N Range#: W Town of: c,t1,'1g4i,/ <br /> *Attach additiona/page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> �6 0 <br /> Tax ID#(1-5 digit number;found on tax statement): /y le 7 o <br /> Proposed Use of Structure/Addition: c ki v crf�Tf✓�r <br /> Anticipated Start Date: � ( ome/Cabin;Comm rcial Business;Bedroom;Deck;etc.) <br /> Building Contractor: 115-4 0vt-1i�r-J Sewer Installer: 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° i", <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> Q /t90 f 40 exUew a 6i u9ll f' 3 �' X <br /> DN Wall 54 � ,�J�d alto <br /> 2 p a / tnvt4 / �//I--ro o w� S // �f <br /> aN / G a I n 7`� e 1 i^S T���� o ti N 2 S CP�G 1�1/� (� Fee Rec: ZCb <br /> °z Check#:ZZq S 3 <br /> / <br /> ® SZy Ski Ac 5r.✓t/ <br /> u / �Gl1�tAJ�gl�� QN4pli�K7D �!//e m r <br /> �, H j �y /2 J/ZO Z� < <br /> M <br /> y j 9Y1 uil <br /> Date of staff site visit: ?0 Z� Initia f s• visit <br /> cc c 3 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: �� �Z✓— <- CD <br /> � <br /> 0 O <br /> UPON APPROVAL: APPLI ANT MUST POST COPY OF CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT tri <br /> Page I of 5 <br /> Burnett County, WI Land Use Application—Rev 07/2025 <br />