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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> a � <br /> Applicant Complete All Sections Below This Line 0' c t� <br /> Permit Types and FeestPlease,check appropriate boxes) n <br /> G <br /> Dwell ing/PrincipaI Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <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 �\ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk I iBunkhouse $250 <br /> Driveways/&Campground Structures $125 1 jWl State Statute 59.692(ly)Structures $350 <br /> Lot LOA <br /> ' <br /> Filling/Grading $150 1 lBoathouse $500 o <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. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> 0 <br /> Property Owner's Name: ��,,%PS 1 �ry�.� N O <br /> o <br /> Property Owner's Mailing Address: f'D I a — �/� $z/ �o � I co� <br /> City State Zip <br /> Property Site Address: <br /> o <br /> Contact's Telephone Number: V57 5`"15;-3 _q5 19 n <br /> _ v <br /> Contact's Email: J 1=�ei, -16, to 49;-/n't i d, 'Q CD <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: @BumettCountyWI.gov ° c <br /> d7�old-3L yV o iv <br /> Legal Description of roperty: l S-.19 16- ()55'-0 1 5-000 N e c4 <br /> Section#: ag Town#:_qL) N Range#: /�15- W Town of: --�Y'Cc_k(.y„^ <br /> *Attach additionalpage if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: 5 P,4 <br /> -� <br /> Anticipated Start Date: "�� —In s— (Home/Cabin;Commercial Business;Bedroom;Deck;ete.) <br /> s 4 <br /> Building Contractor: -se-1 V Sewer Installer: a r <br /> F' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z �. <br /> IQ b461ET' ALL .7tTBA6C5* m <br /> a ,\ <br /> "-r Tp Bt: LdE'p FO FL Hv^4 4 N Hf)B t rA770/U m vl <br /> SEQTtC 'CHAU— LSO Tb %f ACPA1({tV AND SCcu.RCQ <br /> 6y w0,C. a- VAAW 134 B /1 1 2a25 � Fee Rec: lInT <br /> °z Check#: <br /> r <br /> -C <br /> a <br /> rn <br /> n <br /> m <br /> v � <br /> Date of staff site visit: l to 1 Z5S Initials of site visit staff:��� > a <br /> 3 ^ <br /> APPROVED BY LAND SERVICES OFFICIAL: y DATE: W <br /> CD <br /> N <br /> UPON APPROVAL: APPLIC NT MUST POST COPY OF 0 3 N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Q <br /> CD <br /> Cnlli <br /> Page 1 of 5 r�-----1 <br /> Burnett County, WI Land Use Application-Rev 07/2025 �� <br />