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r <br /> S <br /> LAND USE PERMIT APPLICATION—Burnett County, WI g <br /> Applicant Complete All Sections Below This Line <br /> J <br /> Permit Types and Fees:(Check appropriate box boxes) e <br /> O <br /> DwellinyRrincipal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 re <br /> D mg/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 V <br /> ommercial/Industrial Building $300 Addition to CommerciaLlndustrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> n <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(Cl &11) 5200 Addition to Accessory Structure-Commercial(CI &11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Crazebo(W[Stat 59.692(l v)) $350 y <br /> Campground Structures 5125 Filling/Gading $150 <br /> Camping Unit(Birt Months Per Year) $100 Boathouse $500 <br /> ro <br /> Permit Extension(Valid for one year-Only I Allowed) SI00 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. +i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> /L' tJSS� <br /> Property Owner's Name: <br /> C w � <br /> Property Owner's Mailing Address: 7600 G-_ WT eaD a <br /> City State Zip o <br /> Property Site Address: �t/tsv �/o iC d, C <br /> Contact's Telephone Number: _�l!\� I�r/�` J`,�`Z` J ^° <br /> Contact's Email t_J C�� VV 3-7' Ar &_Z_/ t t <br /> 0 <br /> a <br /> Legal Description of Property: W 1 t s <br /> Section#:_ Town#: N Range#:�W Town of: <br /> c <br /> *Attach additional page if needed for lengthy description OR attach a colpy�off the deed OR attach tar system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 3� <br /> Proposed Use of Structure dition: G ltflftl�L= <br /> Anticipated Start Date: l�✓� (home/Cabin;Commercial Business;Bedroom;Deck;etc.) a <br /> n ^— <br /> Building Contractor: z <br /> y <br /> t. <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> �sr� Fee Rec: ISO <br /> z <br /> Date of staff site visit: I Is of site visit staff: C <br /> o z D <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: —�—, m <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 03/2017 ; (� <br /> M <br />