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LAND USE PERMIT APPLICATION— Burnett County, WI a b <br /> Applicant Com Tete All Sections Below This Line ; 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 DwellinglPrincipal Buildings $200 <br /> Commercial/Industrial Building $ Addition to Commercial/Industrial Building $200 I <br /> Accessory Strucrime(Non-Bimkhouse) 50 Addition to Accessory Structure $150 <br /> G1 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(CI & 11) $200 Addition to Accessory Structure-Commercial(Cl&11) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(Iv)) $350 w <br /> Campground Structures $125 Filling/Grading $150 <br /> w <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> ro <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. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Qn <br /> o <br /> s � <br /> Property Owner's Name: {� z <br /> (� !! A/! O y <br /> Property Owner's Mailing Address: A1Vt `VYt - 1 r °v Ti 6 g <br /> �i �CIt State Zip o <br /> Property Site Address: ��1fT "JI o21/� MVV (✓ <br /> 27l � <br /> )154 <br /> Contact's Telephone Number: �f� '� X4/3 W <br /> 5' <br /> Contact's Email: p <br /> _L 1/ 7 V/ Q N <br /> Legal Description of Property: Z-07- / �S/t�] 7 // 2 <br /> Section#: - Town#: N Range#:__/a_W Town of n'1 1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage.* 1 XJ <br /> Tax ID#(1-5 digit number;found on tax statement): Z a <br /> Proposed Use of Structure/ ion: <br /> rt <br /> r <br /> Anticipated Si Date: 1 Hom/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> t � <br /> Building Contractor: ru fewer Installer: z <br /> y <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> — vs4 yy) cd1 sj���Ics h <br /> Fee Rec: I-1 c` c <br /> H <br /> Ch <br /> O <br /> m <br /> 0 Im <br /> Date of staff site visit: 14tiats of site visit staff- _56 Z r_— <br /> PERMIT <br /> PERMIT APPROVED BY ZONING OFFIC DATE: D + �,9_ o w <br /> N l�,ia <br /> Page 1 of 3 0 <br /> Burnett County,WI Land Use Application—Rev 03/2017 > �� <br /> 9 <br /> S <br /> m <br /> m <br />