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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> b <br /> Applicant Complete All Sections Below This Line o' v <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> d <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 g <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwefling/Principal Buildings $200 _ 0 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 1 <br /> G1 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(Cl &11) $200 Addition to Accessory Structure-Commercial(CI &11) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(Iv)) $350 to <br /> m <br /> Campground Structures $125 1 lFilling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 `Z <br /> b <br /> Permit Extension(Valid for one year-Only I Allowed) $100 <br /> 2 \t1 <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. <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name:�A))atJ 3n64 6M <br /> G <br /> Property Owner's Mailing Address: °+ 7 53 A � n <br /> city State Zip o <br /> Property Site Address: � J - —j>/S� / <br /> I� l5�8G�y <br /> Contact's Telephone Number: 6/d <br /> 3 <br /> Contact's Email:�1� <br /> Legal Description of Property: t lt l P , lnov <br /> n' <br /> Section#:- Town#: N Range#:_j_Z_W Town of: <br /> *Attach additional page if needed for lengthy description OR attach n copy of the deed OR attach tar system property page. <br /> U <br /> I <br /> Tax ID#(1-5 digit number; found on tax statement): I ~ <br /> I <br /> Proposed Use of Structure/Addition: F?C-�ey�UR-1 6951��O'r <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) ,r <br /> Building Contractor: Sewer Installer: d z <br /> N <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> �xw(� _Z, 5 - <br /> VA_ <br /> 6� �1�C�� wt�l�ly, ao x �-a �ox �et FeeRec: <br /> rAvs+ �O <br /> a <br /> l�j -o m <br /> O � <br /> Date of staff site visit: Initials of site visit staff- �7 r N Z z <br /> PERMIT APPROVED BY ZONING OFFICIAL: D �7/ z § <br /> § X**Z O S� <br /> Mnm <br /> �0 s <br /> Page 1 of 3 0 V <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> 3 �J <br /> e <br /> x <br /> m <br /> a <br /> m <br />