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LAND USE PERMIT APPLICATION -Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line v <br /> Permit Types and Fees:(Check appropriate box/boxes) <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 O <br /> Commercial/Industrial Building 00 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 ) <br /> 0 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < __ <br /> Accessory Structure-Commercial(Cl &11) $200 Addition to Accessory Structure-Commercial(Cl&R) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 r <br /> iu <br /> Campground Structures $125 1 Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 �.d <br /> 0 <br /> Permit Extension(Valid for one year-Only 1 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. y <br /> Property Owner's Name: <br /> `' < N # <br /> N <br /> Property Owner's Mailing Address: vU to 9 a.5 S 6 a <br /> G � ,, City State Zip o <br /> Property Site Address: �- ` Zsb �-7YA�c�Lpt'Aa t✓ t„V1P) <br /> Contact's Telephone Number:��i L Lo " -731 U 7 00 1 <br /> Contact's Email: <br /> Legal Description of Property: <br /> Imo- I G V a Ly I <br /> Section#: Town#: N Range#: W Town of: <br /> 0 <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): —i <br /> Proposed Use of Structure/Addition: U-l'1 L%k� <1A P,D <br /> Anticipated Start Date: -T S/y v ( ome/Cabin;Commercial Business;Bedroom;Deck;etc.) F <br /> n <br /> Building Contractor: Sewer Installer: z <br /> w <br /> x: <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec: �e <br /> y <br /> z <br /> ti <br /> `o <br /> m <br /> 0 <br /> -1 < n <br /> 1 <br /> Date of staff site visit: nitials of site visit staff: < <br /> PERMIT APPROVED BY ZONING OFFIC DATE: o � <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 03/2017 > �J <br /> T <br /> T <br />