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LAND USE PERMIT APPLICATION — Burnett County, WI acot <br /> Applicant Complete All Sections Below This Line ' v <br /> Permit Types and Fees:(Check appropriate box/boxes) c <br /> O ( <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 °= <br /> � <br /> Dwelling(Principal Building-Multi-Family $300 Structural Alteration to Dwelling(Principal Buildings $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structuae(Non-Bumkhouue) $150 Addition to Accessory Structure $150 n <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(Cl&11) $200 Addition to Accessory Structure-Commercial(Cl&II) $200 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewatk/Driveway&E$1 <br /> Crazebo(WI Stat 59.692(Iv)) $350 <br /> m <br /> Campground Structures Filling/Grading $150 <br /> m <br /> Camping Unit(Six Months Per Year) Boathouse $500 <br /> v <br /> Permit Extension(Valid for one year-Only l AlloweS, <br /> —e <br /> z <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. a <br /> *Items not listed above will be treated as accessory snlictures,,/s/ucchh as:pergolas,landscaping,etc. o <br /> Property Owner's Name: <br /> z <br /> Property Owner's Mailing Address: Ap %,f ort S dA W Yci <br /> a <br /> City State Zip <br /> Property Site Address: pz"> tj� (� <br /> Contact's Telephone Number: <br /> Contact's Email: (-17 f /iTg,i��,`Je f 0° <br /> N�(` I G d <br /> Legal Description of Property: I W /�d � <br /> Section#: I Town#:�N Range#: (� W Town of: //�( �e�y�oY) Ire <br /> *Attach additional page if needed for lengthy description OR attach as copy of the deed OR attach tax system property page.* { <br /> Tax ID#(1-5 digit number;found on tax statement): 3'85 <br /> Proposed Use of Structure/Addition: �LA X a-4X 16 <br /> Anticipated -t 7 S-fjt a $ <br /> Start Date: t <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> � z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITTI]ONS LISTED BELOW: <br /> l Fee Rec:,:�? � <br /> Vi <br /> y <br /> m <br /> N <br /> z <br /> z ���' <br /> Date of staff site visit: ) Initials of site visit staff: ,' <br /> " Z <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: —I z O <br /> Z <br /> 0o o C <br /> Page 1 of 3 0 <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> K <br /> z <br /> m <br /> a <br /> m <br />