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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o ;1 <br /> a <br /> Permit Types and Fees:(Check appropriate box boxes) o <br /> ti <br /> IDwelling/Principal Building-Single Family $300 Addition to Dwellin g�Principal Building-Single Family $200 rn <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling?rincipal Buildings $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 1 n <br /> 0 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> o \ t <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl & 11) $200 Addition to Accessory Structure-Commercial(Cl & 11) $200 o <br /> Deek%StairslPatio%Retaining Wa1VSidewalklDriveway& Gazebo(WI Stat 59.692(lv)) $350 <br /> Campground Structures $125 Filling/Grading $150 P. <br /> w <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 �^o <br /> ro <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 t^ <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 Towers&Signs require a di}erent application form,see corresponding application and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping, etc. <br /> G <br /> Property Owner's Name: �4v.� �a�v�ra\_1 C a�. N <br /> Property Owner's Mailing Address: S�1 QS 10. S ))tS-Sol`� Q <br /> - s <br /> City State Zip o <br /> Property Site Address: 03 \)4v`.> X-)V W-k13 b W'. _ m <br /> w <br /> Contact's Telephone Number: 8 G - q(w L o 00 <br /> Contact's Email: Seto�gv�Q %-j <br /> Legal Description of Property: 1_p (-%AA V l t lm's <br /> Section#: Lt. Town#: 3Q N Range#: 16 W Town of: LK a Koti <br /> *Attach additional page if'needed Jbr 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): 1102-7- <br /> Proposed <br /> tO2-ZProposed Use of Structure/Addition: u kk-k j 16 W a_wt%k- e1.5 <br /> Et ntiCipafed Start Date: R 1 l� Ufom�mmercial Business;Bedroom,Deck;etc.) <br /> Building Contractor: A _— Sewer Installer: N A a z <br /> a <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 6c'Tweeh �o.,s- <br /> Fee Rec:�� <br /> YY�US-�' ID 2, �v���/ Y e�e��U Te rl v <br /> 1 M <br /> Date of staff site visit: In'tials of site visit staff: m rte- <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br /> �-- � s r? � <br /> 90 <br /> o <br /> Tr <br /> C: n(�r <br /> Page 1 of 3 8 <br /> Burnett County, WI Land Use Application—Rev 0312017 C� <br />