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_LAND USE PERMIT APPLICATION - Burnett County WI a b <br /> i <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> c t <br /> d <br /> Dwelling/Principal Building-Single Family $300 11 Addition to Dwelling/Principal Building-Single Family $200 g <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 <br /> O <br /> Commercial/Industrial Building $300 1 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 1 Addition to Accessory Structure $150 <br /> M <br /> Bunkhouse $250 1 Structural Alteration to Accessory Structure $150 °< <br /> Accessory Structure-Commercial(Cl &Il) $200 1 Addition to Accessory Structure-Commercial(Cl &I1) $200 o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(l v)) $350 m <br /> Campground Structures $125 1 Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 1 Boathouse $500 <br /> m <br /> Permit Extension(Valid for one year-Only l Allowed) $100 S, <br /> _ <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. z� <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. c <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. cn <br /> c <br /> N;Property Owner's Name: /ys z <br /> z <br /> Property Owner's Mailing Address: ar�.�fil�i: �(/• �/ o <br /> City State Zip o C� <br /> Property Site Address: z <br /> Contact's Telephone Number: o <br /> 0 <br /> Contact's Email: r �{ I O d <br /> Legal Description of Prope$ /V /2/d 2 G��1 V, Y„ 1'a� 6o'� JLC� F, <br /> Section#:�Town#: L�U N Range#: �S W Town of: U uy 4J.9 x7 <br /> H <br /> *Attach additional page if needed 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): H <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: Sof— f^1 )(Home/Cabin;Commercial Business;;Bedroom;Deck:etc.) kA <br /> Building Contractor: LO Uiv-1 llaAa )//U7. 4c a4ewer Installer: !f>fln i,Ii/ z <br /> y <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY _ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: U <br /> t�T vin t7 Cr�`1a�, ��1e ti?�leSc <br /> M\J`3J1 `S Fee Rec <br /> H <br /> tJ <br /> / -1 z Y Y <br /> Date of staff site visit:` 1 Initials of site visit staff. Z <br /> _ I <br /> PERMIT APPROVED BY ZONING OFFICIAL DATE. ' — <br /> Z`0 <br /> C=) <br /> Page 1 of 3 <br /> Burnett County, WI Land Use Application—Rev 03/2017 > <br /> b <br /> m <br /> a <br /> m <br />