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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a <br /> y. <br /> Applicant Complete All Sections Below This Line 0' <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> a � <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 $300 Addition to Commercial/Industrial Building $200 £ <br /> Accessory Structure(Non-Bunkhouse) 150 Addition to Accessory Structure $150 <br /> n <br /> Bunkhouse Structural Alteration to Accessory Structure $150 < _ <br /> Accessory Structure-Commercial(Cl &I1) $200 Addition to Accessory Structure-Commercial(Cl &11) $200 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 y <br /> w <br /> Campground Structures $125 Filling/Grading $150 "�— <br /> w <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> �u <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. ° <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. ,o <br /> E. <br /> Property Owner's Name: I u Ll <7 ami+V <br /> Property Owner's Mailing Address: I�� nrt SE?i�/'llre SD/YIP/'SGT �/� Sy <br /> �-1 Ci State Zip v <br /> Property Site Address: 27177San;_czn )?m / �/�3 <br /> Contact's Telephone Number: 715-78/- 7053 N1 f� <br /> Contact's Email: Po a irf t r V1 . ! 1 V5 ez //O7' m q/ 1. C�O/1y\ p <br /> Legal Description of Property: PC k Gd v L o! � (L OT 6 Q —5X) <br /> Section#: Town#: N Range#: _W Town of: Mee-119911 <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach acopy of the deed OR attach tax system property page.* \ <br /> Tax ID#(1-5 digit number;found on tax statement): 1/237 n -� <br /> Proposed Use of Structure/Addit}�on: /8 W x 1P I` Sto/d a(eJ h ed <br /> Anticipated Start Date: 7 s'3 " / (Home/Cabin;Co mercial Business;Bedroom;Deck;etc.) <br /> An e <br /> Building Contractor: Sewer Installer: y z <br /> N <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY —§ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> k\ '�S C C Fee Rec: (7'''� <br /> M <br /> N <br /> O <br /> n C _-� <br /> Date of staff site visit: _ I Initials of sitp visit staff: a C <br /> F-- <br /> PERMIT <br /> PERMIT APPROVED BY ZONING OFFIC DATE_ !�� -I ►-• <br /> O rVc <br /> Page 1 of 3 0 I'!f <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> m <br /> A <br /> M <br />