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2��7 LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> Applyatnt Compkle All Sections Below This Line 4. i <br /> Permit Types and Fees:(Check appropriwe box/boxes) <br /> Dwelling/Prmcipal Building-Single Family 5300 Addition to Dwelling/Principal Building-Single Family $200 _ }= <br /> Dwelling(Principal Building-Multi-Family $300 Addition to Dw itinsPrmcipal Building-Mufti-Family 5200 O n <br /> Commercial/Industrial Building $300 Addition to CommerciaVlndus[rial Building $200 `' �T <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse 5250 C' <br /> Addition to Acc.Structure 5150 Addition to Accessory Structure-Commercial(Cl&Il) $200 �. <br /> Accessory Structure-Com ercial(Cl tit 11) 5200 Gazebo(WI Stat 59.692(lv)) $350 <br /> Deck/Stairs/Patio/Retaining WaWSdewalk/Driveway& FillineGading $150 <br /> Campground Screen Porches $125 Boathouse 5500 <br /> Camping Unit(Six Months/Year) 5100 0 <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 S �. <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 Afferent appbcabon form,see corresponding application andjees. <br /> 'Items not listed above will be treated as accessory structures,such as: olas,landscaping,etc. Z <br /> Property Owner Is Name: )du �Ahl 6c7 <br /> M// 5Property Owner's Mailing Addressi K <br /> C state Zip <br /> Sip <br /> Property Site Address: q3q DPr <br /> C 8 <br /> � <br /> Contact's Telephone Number. 61z— Ui —2n5-3 <br /> Contact's Email: 1h hat�Frt,�� 1�2� %a� y� OfA 5? <br /> 5. <br /> Legal Description of Property: oT <br /> � 6-5M <br /> Section#:�_Town#:-3- `'�N Range#: W Town of: y <br /> 0 <br /> •Attach additional page ifneeded 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): 96z <br /> Proposed Use of Structure/ d 'tion: C0.b i A <br /> e <br /> Anticipated Start Date: � ()117 (IfomeJCabin;Commercial Business;Bedroom;Deck;etc.) <br /> r ,,tt1/1� 1J � <br /> Building Contractor.�t2r otiJ7VCY ���n gw�ns Sewer Installer. f>bdN�hS �IGmJ� Gl uvi. Z <br /> AREA BELOW TMS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS <br /> //PERMIT <br /> `,IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (A�I—}fin/,�elln f'u{).S vc.� 1 <br /> L�\4ahJtl l I �CY)C, w 1��r� IcaC,Q FeeRec3nDtm <br /> Vl <br /> pN <br /> V <br /> 3- 1 � ( " Z Cs� <br /> Date of staff site visit: Initials of site visit staff: o <br /> O Z -4 <br /> bZ <br /> PERMIT APPROVED BY ZONING OFFIC DATE: I — � 0 C o <br /> Z <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 02/2017 � �'7 <br />