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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a � c <br /> Applicant Complete All Sections Below This Line '' <br /> Permit Types and Fees:(Check appropriate box1boxes) ° <br /> Dwelling/Principal Building-Single Family $300 [o Dwelling/Principal Building-Single Family $200 <br /> Addition 0 <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 i <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 C1 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(Cl & 11) $200 Addition to Accessory Structure-Commercial(CI &11) $200 91 <br /> Gazebo(WI Stat 59.692(lv)) $350 Cn <br /> _ 1 <br /> =- w <br /> i Camping Unit(Six Months Per Year) 100 13oathouse $500 2 <br /> 9 <br /> Permit Extension(Valid for one year-Only I Allowed) $100 11 1 r- 3 <br /> 0IA <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. ZP <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. c <br /> Jj <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> Property Owner's Name: Anlft,.� t z <br /> Property Owner's Mailing Address: J � S t ` c <br /> t <br /> Cl City State Zip C7 <br /> Property Site Address: <br /> Contact's Telephone <br /> -,Number: <br /> AAate!S o �? <br /> Contact's Email: LV�CH X1.1 t1n FA�� �_ o <br /> Legal Description of Property: L-0 CSMN Vt1l \4 /R e4oLI <br /> Section#: Ike Town#:_4%__N Range#: y W Town of: s Gd ) <br /> y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* f <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): 1 <br /> Proposed Use of Structure/A diti r C) S� <br /> Anticipated Start Date: -7 (Home/Cabin;Commercial Business;Bldroom;Deck;etc.) F <br /> n <br /> Building Contractor: Sewer Installer: � z <br /> N T <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 0��c� <br /> b 5 t l C- ° S Fee Rev- <br /> 30 <br /> 09 <br /> C <br /> li �1 *4 M <br /> Date of staff site visit: �'$ _ 1 / Initials of site visit staff: s� -I I' <br /> PERMIT APPROVED BY ZONING OFFICIAL DATE: I ® o l� <br /> C: <br /> m z <br /> Pagel of 3 0 <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> m <br /> m <br /> X <br /> M <br />