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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> y ~ 1 <br /> Applicant Complete All Sections Below This Line g' v <br /> Permit Types and Fees:(Check appropriate box/boxes) ° <br /> d <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 \ <br /> Commercial/Industrial Building 5300-1 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkbouse) $150 Addition to Accessory Structure $150 <br /> G7 <br /> Bunkhouse $250 IStructural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(Cl&11) $200 Addition to Accessory Structure-Commercial(Cl&II) $200 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 <br /> w <br /> Campground Structures $125 Filling/Grading $150 <br /> m <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> •o <br /> Permit Extension(Valid for one year-Only l Allowed) $100 <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. o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> Property Owner's Name: _bprQr LU►lOclerellaCae �LL_ST 4 <br /> n O y # <br /> Property Owner's Mailing Address: K/ <br /> 6 <br /> p n City State Zip G <br /> Property Site Address: ti�c� <br /> Contact's Telephone Number: 7�rj-�`Q/— �,� r/'� _ ) _ j <br /> Contact's Emai1:��Cx7bUg/^ <br /> Legal Description of Property: PCG GO f [.pt 6 �• (�TT� <br /> Section#: 35 Town#:_ ()_N Range#:__//W Town of (C/�SD(7 <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):_ CD©�Gj H I <br /> Proposed Use of Structure/Addition: V6rCZ9C. 30 X � 0 <br /> Anticipated Start Date: 7/�24��/',0Y Nome/Cabin;Commercial Business;Bedroom;Deck;etc.) X <br /> Building Contractor: erre tr I!?� Sewer Installer: y z <br /> AREA BELOW THIS L E RESERV D OR ZONING STAFF COMMENTS/CONDITIONS ONLY y <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> / \ Fee Rec: /51• <br /> 6,,� � o��� a <br /> n <br /> Date of staff site visit: Initials of site visit staff. > c <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br /> -tea-1� 4 <br /> 0 <br /> Page 1 of 3 ; v <br /> Burnett County, WI Land Use Application—Rev 03/2017 y <br /> m <br />