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LAND USE PERMIT APPLICATION— Burnett Countv, `N'I aLA <br /> _ <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Check appropriate box/boxes) n <br /> v <br /> Dwelling/Principal Building-Single Family 5300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 1 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> 5250 Structural Alteration to Accessory Structure $150 <br /> Accessory StructutrConunercial(CI &II) $200 Addition to Accessory Structure-Commercial ICI . 10 $200 t- <br /> o <br /> Deck.Stairs Patio Retaining Nall Sidewalk,Driveway&, ,Gazebo(NIStat 59.692(lv)I $350 <br /> Campground Structures $125 V001Filling;Grading _ •= �• <br /> Camping Unit(Six Months Per Year) $100 Boathouse -$500 <br /> `o <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 S <br /> Z <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. jj P <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. �' <br /> °o <br /> */terns not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 9 <br /> Property Owner's Name: Amika;.� ri.a <br /> CC o � <br /> Property Owner's Mailing Address: J M J ` ' n <br /> d City State Zip o <br /> Property Site Address: o2Q (A-) CrtsC-yK* L&L� lA W @ -ItA* W L S!jig 3 <br /> Contact's Telephone Number: SS-)-a�8 S <br /> Contact's Email: <br /> N <br /> Legal Description of Property: LQ�43 CSM ��� <br /> Section#:�_Town#:�_N Range#: �{ W Town of: S C-6 ) <br /> -s <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): /03 -a <br /> Proposed Use of Structure/ diti n: b vc*� s Fin i3�. qm A t 6 �O�F� <br /> Anticipated Start Date: 7 (Home/Cabin;Commercial Business: Deck;etc.) <br /> Building Contractor:Tn <br /> Sewer Installer: z <br /> z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Recof/�•a) <br /> 1 r 1 <br /> J N <br /> n M e <br /> Date of staff site visit: Initials of site visit staff. <br /> " <br /> '3 1 r h t in <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE O o <br /> C: ti W" <br /> Page 1 of 3 c -G <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br />