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LAND USE PERMIT APPLICATION — Burnett County, WI G <br /> 00 <br /> Applicant Complete All Sections Below This Line E <br /> Permit Types and Fees�Please,check appropriate boxes) b <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 fff��� f•�'���` <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 /> 7 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> v <br /> Solar Panels(Stand alone or roof mounted) 1 $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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> Property Owner's Namc:_1 st.41eS Lt/ Mm✓ESL LeA4 �����s o" c <br /> Property Owner's Mailing Address: a A <br /> City t�State Zip <br /> Property Site Address: 24.5-e ! ILOK' Leh I 4� S.arrrY✓ k1-� ;� 7 �/ <br /> O C <br /> Contact's Telephone Number: <br /> b <br /> Contact's Email: W a `t •Co h'? Q <br /> **If staff has a ques ion about this application,you will be contacted via email. Make stare your email address is N <br /> legible and your email provider will accep e ail o th low g odd ss: (cd;BunlettCountyW1.gov <br /> � ' �• Pp, <br /> Legal Description of Property:frzd <br /> Section 10 Town#:1_N Rangc#:� W Town of. 4i <br /> *Attach additional page if'tieeded for lengtht^description OR attach a cow of'lhe deed OR attach lae system properly page. <br /> o <br /> Tax I#(1-5 digit number;found on tax statement): 1,S7 7 9 o <br /> Proposed Use of Structure/Ad ition: N <br /> Anticipated Start Date: (Home/Cahin:Commercial Business;Bedrown:Deck:ete.) <br /> Building Contractor: Sewer installer: cr, S <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMNIENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z W <br /> .6 y,'v-z�Cty sou l� 6� wt oil+` eat his Gl a ve, a Zo f-7L C./egvty/' <br /> H i <br /> y Pee Rec: <br /> Check#: <br /> rn <br /> Date of staff site visit: Initi s o site visit staff: z,. > b <br /> t � <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ?-0Z <br /> l <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> 00 a� r� <br /> CD � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �— <br /> Paget of 5 <br /> Burnett County,WI Land Use Application—Rev 07/2025 <br />