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b <br /> LAND USE PERMIT APPLICATION— Burnett County, WI t~ <br /> a � � <br /> - b <br /> Applicant Complete All Sections Below This Line �! <br /> Permit Types and Fees:(Ckeck appropriate boxBoxes) � <br /> DuellmVPrincipal Building-Single Family $300 Addition to Dwc ing/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Budding $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 <br /> 41 <br /> Addition to Acc.Structure $150 Addition to Accessory Structure-Commercial(Cl&I1) $200 <br /> Accessory Structure-Commercial(Cl &11) $200 Gazebo(WI Stat 59.692(lv)) $350 t <br /> DecLIStairs/Patio/Retaining Wall/Sidewalk/Driveway& Fillm&g Gradmg $150 <br /> Campground Screen Porches <br /> P6r $125 Boathouse $500 lv <br /> Camping Unit(Six Months/Year) $100 <br /> rn <br /> Permit Extension(Valid for one year-Only I Allowed) $100 r. <br /> o ' <br /> 'NOTE:After-the-fact(whets no permit is obtained prior to construction)is up to three times the normal fee. L <br /> Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> 'Items not listed above will be treated as accessory structures,such as:pergolas,landscaping, etc. I -� <br /> � � �/ 6 � <br /> PmperryC�wner'sName: /��//(.�7/itZ He(se'.-- <br /> Property Owner's Mailing Address: 7 F3 1,G Q A Ai o. <br /> [ n City State Zip C7 <br /> Property Site Address: <br /> I <br /> Contact's Telephone Number: (I � <br /> N �u <br /> o <br /> Contact's Email: IIIII&%4 7l-klher 'COn <br /> S <br /> G _ <br /> Legal Description of Property: Lc- 10 06t ole O ;f tS'a.-✓ Pt4te I` SO1 <br /> Section#: -7 Town#: N Range#: W ToTof: � e LAVIQ— <br /> 0 <br /> •fttach additional page if needed for lengthy description OR attach a copy of Lile end//OR attach tax system property page.• 3 1 <br /> Tax 1D#(1-5 digit number;found on tax statement): 3 <br /> Proposed Use of Structure/Addition � <br /> 7-�-7i ; <br /> Anticipated Start Date: JC/�G` p(Q ,Tc.t�/ (Home'Cabin;Commercial Business:Bedroom;Deck;etc) <br /> eck;etc.) r <br /> Building Contractor: Sewerinstaller: <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTSICONDTTIONS ONLY <br /> THIS P RMIT IS SUBJECT TO ALL CONDITIONS IION/S LISTED BELOW: <br /> S�D e U/5 i� V - PG.� )` AZt wy t <br /> Fee RecIL7�cc <br /> C ---�`=0 <br /> Z c <br /> Date of staff site visit: 7--S-- 17 I rtia of site v' ' staff: z g� <br /> tz tl u u <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: 7-11— '7 Q oN <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 10/2016 �[—� <br />