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co -0 <br /> LAND USE PERMIT APPLICATION—Burnett a Count0 <br /> y, WI r <br /> 17i <br /> Applicant Complete All Sections Below This Line J <br /> Permit Types and Fees:(Check appropriate box/boxes) a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 O <br /> Commercial/Industrial Building $300 Addition to Commercial/industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> n <br /> Bunkhouse $250 1 Structural Alteration to Accessory Structure $150 <br /> a <br /> Accessory Structure-Commercial(Cl &I]) $200 Addition to Accessory Structure-Commercial(Cl &It) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(Wi Stat 59.692(l v)) $350 <br /> Campground Structures $125 <br /> Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> ry <br /> Permit Extension(Valid for one year-Only I Allowed) $100 r. � <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. p Q-- <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. o <br /> *Items not luted above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> p " n <br /> Property Owner's Name: hL l�. �� Lara ' <br /> z <br /> Property Owner's Mailing Address: 2111 <br /> J60, 1,N n 4 ,Ck <br /> City <br /> IIState <br /> tateJ Zip <br /> Site Address: oJLk L/V �/ h5Wr 1 <e <br /> da <br /> Contact's Telephone Number: <br /> Contact's Email: C�Ir�� M C U('-I(SGA �� •(1/�T o <br /> y <br /> oaf � CSM �ra� <I3 RJ<ck- k R <br /> Legal Description of Property: � dt. W <br /> n <br /> Section#: Town#: N Range#: W Town of: _ ClC�Oj <br /> y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a <br /> Tax ID#(1-5 digit number;found on tax statement): / � s <br /> Proposed Use of Structure/Addition: YY b LW-6-� S'1� <br /> Anticipated Start Date: /�� r <br /> p /r1l(G 41''--�S �((��f�J (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � <br /> Building Contractor: �a i GYUrtA. 6S 11 (6 l X55 Sewer Installer: z <br /> '� m <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> W's V tA- �4t, O 6r�O-\Y�to ��I —7- -S 1- ) <br /> ` h e,� <br /> Qe fs 6 110 vJ n S Fee Rec: 9b <br /> 1 Ct- m <br /> o <br /> z <br /> L) <br /> ED <br /> �/J/ <br /> Date of staff site visit: 7'17— 17 I tials f site vis i tall: C <br /> U o 33 D ;I <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: iV <br /> r)Z- 11 i." 6-9f� <br /> W <br /> Page 1 of 3 0 6 8 N <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> M <br />