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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> d � � <br /> a - b <br /> Applicant Complete All Sections Below This line o v <br /> Permit Types and Fees:(Check appropriatebox/boxes) r <br /> j <br /> d <br /> DwellingPrincipal Building-Single Family $300 Addition to DwLllingTrincipal Building-Single Family 5200 v <br /> Dwelling Principal Building-Multi-Family $300 Structural Alteration to Dwdling/Principal Buildings $200 1 C <br /> CommcrciaNridustrial Building 5300 lAdchtion to Commercialllndustrial Building $200 m <br /> Aeeessory Structure(Non-Bunkhouse) $150 jAddition to Accessory Structure $150 a <br /> ^1 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 I < <br /> Accessory Structure-Commercial(Ct &Il) $200 Addition to Accessory Structure-Commerciat(CI &II) $200o <br /> Deck/Stairs/Patio,Retaining Wall/Sidewalk/Drivetvey& Gazebo(WI Stat 59.692(1 v)) $350 <br /> Campground Structures IS125 Filling/Grading $150 .. ' <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> Permit Extension(Valid for one year-Only I Allowed) $loo11 <br /> o — <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 powers&Signs require a different application form,see corresponding application and fees, o <br /> *llems nol hsled above will be treated as accessory structures,such as:pergoias,landscaping etc. <br /> / L � o <br /> Property Owner's Name:_.- '`� <br /> Property Owner's Mailing Address:__ <br /> Cit, State Zip C7 <br /> Property Site Address; Z i 3C� :Lti ?d; Z� <br /> Contact's Telephone Number: 17- "' �40 t J J'o " a <br /> Contact's Email: /G/C <br /> Legal Description of Property: �G L �d1/ I 7 (�4o/_ <br /> - - <br /> Section #: Town#: N Range#: W Town of: <br /> y <br /> *Attach additional page if needed far lengthy description OR attach a copy of the deed OR attach tax system property page.* I <br /> Tax ID#(1-5 digit number;found on tax statement): Z-Igo 9 n f�tor, � 1 <br /> Proposed Use of Structure/Addition: 7>C-K .L �e,t J C-e.�j;h IV - <br /> r <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> m <br /> /J r n <br /> Building Contractor: .�-F S�/�' Sewer Installer:�-/4 1 4 t.. <br /> a <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTSICONDIT IONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec:J e <br /> ( N <br /> IN <br /> z W <br /> _ C) C <br /> y <br /> Date of staff site visit: Initials of site visit staff: MC <br /> -tea- 1 � ° gym <br /> PERMITAPPROVED BY CONING OFFICIAL_ DATE: �►M Fa <br /> Z <br /> 0 O <br /> Page 1 of 3 o <br /> Burnett County, WI Land Use Application -Rev 03/2017 <br />