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I <br /> LAND USE PERMIT APPLICATION—Burnett County, WI <br /> Applicant Complete All Sections Below This Line ' tlig <br /> en <br /> Permit Types and Fees:(Check appropriate box/boxes) a a <br /> d <br /> X(Dwelling/Principal Building-Single Family $300 (Addition to Dwelling/Principal Building-Single Family $200 C <br /> I Dwelling/Principal Building-Multi-Family $300 u Structural Alteration to Dwelling/Principal Buildings $200 —.8.-O <br /> 1Commercial/Indatrial Building $300 'Addition to Commercial/Industrial atrial Building $200 <br /> P. <br /> Accessory.Structure(Non-Bunkhouse) $150 (Addition to Accessory Structure $150 <br /> t7 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 . %Ili <br /> 'Accessory Structure-Commercial(C1 &II) $200 Addition to Accessory Structure-Commercial(Cl &II) $200 0 1\ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(1v)) $350 v, <br /> (CamoundStructires <br /> Ply $125 Filling/Grading $150 m <br /> 'Camping Unit(Six Months Per Year) $100 'Boathouse $500 ,2.o <br /> co iii, <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 I c <br /> z • <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. c <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. d t <br /> FScr <br /> Property Owner's Name: 1) ((,L K if (7.4Ko` C M e_ T"NI Ty Re--- "a <br /> A <br /> Property Owner's Mailing Address: i 113$ q '"5-F_ Z N. M.\/ 55077 ceD <br /> o. <br /> City State Zip o k i <br /> Property Site Address: Le-Er FR p No FA,t -!t< y,_-T- <br /> it <br /> Contact's Telephone Number:12/B - 4'90- (7 7 5 0 - 6 r,---14..E N b <br /> =- U <br /> Contact's Email: 1DCrpiC f,vey,,Q,ii ) �'14mA,y <br /> 35 , d-pc, d Q\ <br /> C.) 5,- <br /> Legal Description of Property: SCS A 7�.ac yy.A 'dN <br /> Section#: Town#: N Range#: W Town of: Cl) H <br /> .3/=) o • <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* g <br /> I. <br /> Tax ID#(1-5 digit number;found on tax statement): .54 9/ - <br /> 1SI <br /> Proposed Use of Structure/Addition: /We klerr <br /> Anticipated Start Date: ie.,-0/ - ,2 0 2 a (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) X <br /> .lout Pae K 7''5-'?7 7-05 4S el r,,,fl <br /> Building Contractor: PAP,ii u.« 6"../.rko 7--,,,.i Sewer Installer: J1s 1 ..'J y z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY H <br /> THIS PERMIT IS SUBJEC TO ALL CONDITIONS LISTED BELOW: <br /> 0 <br /> „ii <br /> flp�Ne (t', exceed i be . Ter 541v-;) ,)-17 Fee Recr50:,0 <br /> k d:s+1,-boua v11441;n 50 .c-1- ok- OhWIM t �D ? <br /> a Flo ► . C <br /> rn it n 5,1y,.(c /,e be-1-,Nem+ dose Ara DNwIi'l �'�( i i e- m <br /> I�r v5e �(rn,+ G0.zebb CWT 5.64 55. 69 )) . <br /> l 4 t <br /> ` C^ <br /> Date of staff site visit: 9'/ 1 l�i Initials o>site visit st j'•/� . a U11U <br /> C to .• R'1 <br /> �!�' - i ��' lob a 3 c_ <br /> PERMIT APPROVED BY ZONING OFFICIAL: �L .// DATE: <br /> /� 2 ' fv uuu <br /> r a o0 <br /> , D C 1V C:� <br /> / Page 1 of 3 g. N t4 <br /> Burnett County,WI Land Use Application-Rev 03/2017 mITN <br /> 'a <br /> m <br /> m <br /> 1 <br />