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LAND USE PERMIT APPLICATION—Burnett County, WI 5r <br /> e r V <br /> Applicant Complete All Sections Below This Lime a `+ <br /> g a <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> Dwelling/Principal Building-Single Family 5300 Addition to DmUing/Prmcipal Building-Single Family $200 <br /> Dmlling/Principal Building-Mufti-Family $300 Addition to Dwelling/Principal Building-Muhi-Family $200 <br /> CommerciaVlndustrial Building $300 Addition to Commercial/Industrial Building $200 r <br /> Accessory Stnsature(Non-Bunkhouse) $150 Bunkhouse $250 <br /> unG' <br /> Addition to Ace.Structure $150 Addition to Accessory Structure-Commercial(Cl&11) $200 �. <br /> Accessory Structure-Commercial(Cl&Il) $200 Gazebo(WI Stat 59.692(lv)) $350 <br /> Deck/StamTatio/RetainingWaWSidevvaWjDrive%wy& Filimg(Gradmg $150 yy� <br /> Campground Screen Porches $125 Boathouse 5500 T" <br /> Camping Unit(Six Months/Year) $loo <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 <br /> *NOTE:After-thafacx(when no permit is obtained prior to construction)is up to three times the normal tee. <br /> 0 <br /> 'Communication Towers&Signs require a different appheationform,see correspond ng application andfees. $ <br /> *Items not Bsied above will be treated as accessory structures,such as:pergolas,landscaping,etc. ro_ <br /> Property Owner's Name: w 6 1 AS o <br /> Property Owner's Mailing Address: �i� 23n4 hvIP llw Yt S. <br /> Property Site Address: �7t7� f er-i (ttWt Xc `sa Qk 1k jvYv/1r I ti 1p State Zip <br /> Contact's Telephone Number. 'ZL 1— Z1 � ao 1 <br /> 1 <br /> t 11 j w <br /> Contact's Email: t d< V, NAwk-, Sanf�,.�I c on <br /> YO <br /> i <br /> Legal Description of Property: L OT-3 G M ;?_X <br /> 's <br /> Section#: _Town#:_3!'S N Range#: 5 W Town of: Zi FJC y <br /> 0 1 <br /> 'Attach additional page if neededfor lengthy description OR attach a dopy of the deed OR attach tax system property page.' l <br /> Tax ID#(1-5 digit number,found on tax statement): q ,I <br /> Proposed Use of StmctuWAddition: co k^J u n <br /> Anticipated Start Date: (Ho C in:Commercial Business;Bedroom;Deck;eta) <br /> n <br /> Building Contractor: Sewer Installer. F Z <br /> z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> �6 Ll/Gt 1"d r �o (�a mP�J l"�✓� J S e/V Si !e , t� <br /> Fee Rectoj_OD <br /> y <br /> VI <br /> IJ <br /> zz) <br /> C <br /> Date of staff site visit: 7'/9"1-7 sof site stab: IM __v <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: ' ) C o <br /> Page 1 of 3 Z V <br /> Burnett County,WI Land Use Application—Rev 021.2017 -� �� <br />