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LAND USE PERMIT APPLICATION—Burnett County, WI g <br /> Applicant Complete All Sections Below This Ione e' i <br /> Permit Types and Fees:(Check appropriate box/boxes) iK <br /> DaellinglPrincipal Building-Single Family $300 Addition to DKeuing/Principal Building-Single Family $20o <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dscelling/Principal Building-Multi-Family $200 .. n <br /> Commemial/Industrial Building $300 Addition to Commercial/Industrial Building $200 I rn <br /> Accessory Siructme(Non-Bunkhouse) $150 Bunkhouse $250 ~ <br /> I � <br /> Addition to Ace.Structure $150 Addition to Accessory Structure-Commercial(Cl&11) $200 <br /> Accessory Structure-Commercial(Cl&11) $200 Gazebo(WI Stat 59.692(1,)) $350 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& _ Filling/Grading $150 w <br /> Campground Screen Porches $125 Boathouse <br /> $500 <br /> Camping Unit(Six Months(Year) $100 b <br /> Permit Extension(Valid for one year-Only 1 Allotred) $100 �- <br /> z <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. c <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> *Items not listed above wdl be treated as accessory structures,such as:pergrolas,landscaping,etc. <br /> // rA <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: 2 vNNe� �Atct= 1CrX SSG �S 5yfis <br /> City State Zip (� <br /> Property Site Address: �CLi�Loj,2 <br /> Contact's Telephone Number. <br /> N <br /> Contact's Email: <br /> Legal Description of Property: 7/fL'�j�� 5. <br /> Section#: Town#: N Range#: W Town of: y (� <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ! <br /> Tax ID#(1-5 digit number;found on tax statement): H I <br /> Proposed Use of Structure/Addition: �r`40f�� 3 seal 5071 geX� 'Z.$) POZ64 <br /> Anticipated Start Date: <br /> //fiw-a- /� '1�Jt7 (Romdcabin Commerc al Business;Bedroom;Deck;etc.) <br /> Building Contractor:lCwr a /nr lleQ Sewer Installer: '0" n z <br /> w <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY U <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec.oDav-0D <br /> C <br /> M <br /> 7 M m <br /> Date of staff site visit: a� —I � �/- � I -ti aLs of site visit staff is N� MW <br /> a--- 1 S l z n <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: z O <br /> Page 1 of 3 Z o <br /> Burnett County, WI Land Use Application-Rev 1/2017 :� r—��, <br />