Laserfiche WebLink
LAND USE PERMIT APPLICATION —Burnett County, WI g <br /> V �1 <br /> Applicant Complete All Sections Below This Line =' <br /> 6 � <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> 0 <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 g <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 Cj) ^ <br /> Commercial/industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 7 1 <br /> o — <br /> .Addition to Acc.Structure $150 Addition to Accessory Structure-Commercial(Cl &11) $200 It <br /> Accessory Structure-Commercial(Cl &11) $200 Gazebo(WI Stat 59.692(lv)) $350 o <br /> Deck/Staits(Patio/Retaining WaWSidewalk/Driveway& Filling/Grading $150 m <br /> Campground Screen Porches $125 Boathouse $500 0 <br /> iv <br /> Camping Unit(Six Months/Year) $100 � <br /> ro <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 <br /> p � z <br /> *NOTE After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. N c <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. <br /> Property Owner's Name: <br /> y3 s / D KJ1 o <br /> Property Owner's Mailing Address: "a <br /> City State Zip O G <br /> Property Site Address: S Q(i✓t <br /> i <br /> Contact's Telephone Number: N °` t <br /> Contact's Email: 6111, Alp 16 (0-0C /(,t'E✓!f��. <br /> t7 <br /> Legal Description of Property: <br /> C4414-7 �l.-4 l6F P(i'i +� L+ O ` 22 5. <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): <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: n z <br /> D <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-.20 —1w <br /> C <br /> Z <br /> Z <br /> � M S�Z <br /> Date of staff site visit: 3 —�—�- 1 Ini ' Is of site visit taff: 0 -i <br /> `� Z C) <br /> PERMIT APPROVED BY ZONING OFFICIAL• 1" � DATE! � I� n O _o <br /> Page 1 of 3 z <br /> Burnett County,WI Land Use Application—Rev 1/2017 <br />