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LAND USE PERMIT APPLICATION - Burnett County, WI a ro <br /> M <br /> Applicant Complete All Sections Below This Line $ r v <br /> o <br /> Permit Types and Fees:(Check appropriate box/boxes) 1K, O <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 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 g 1 <br /> P <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl&I I) $200 Addition to Accessory Structure-Commercial(Cl &11) $200 o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Sat 59.692(iv)) $350 w <br /> Campground Structures $125 Filling/Grading $150 �' S <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 b <br /> ro <br /> Permit Extension(Valid for one year-Only I Allowed) $100 r- <br /> o <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. c <br /> Mems not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> Property Owner's Name: C( 1 � <br /> — a 6? w 4�-awvteylz <br /> Property Owner's Mailing Address: `J ✓ef in 1/U5, <br /> -7Ol7 rwk /,, City State Zip o <br /> Property Site Address: ( �(1 <br /> Contact's Telephone Number: o <br /> 5' ) <br /> Contact's Email: <br /> y <br /> Legal Description of Property: I ] <br /> Section#: CA <br /> _Town#: N Range#:-1 1L W Town of y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* a <br /> Tax ID#(1-5 digit number;found on tax statement): Clio <br /> Proposed Use of Structure/Addition: �h4e, <br /> Anticipated Start Date: N (Home/Cabin;Commercial Business;Bed wom;Deck,'etc.) <br /> n � � / n <br /> Building Contractor: M ✓ h �w 0 Sewer Installer: W' 0 z <br /> z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> � fV <br /> C ovC 0 <br /> Fee ReL:?m <br /> y <br /> t7 <br /> m <br /> C <br /> H zD <br /> Date of staff site visit: Initials of site visit staff: - <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE! 0c <br /> O '" <br /> m LI U IJ <br /> Page 1 of 3 0 <br /> Burnett County,WI Land Use Application—Rev 03/2017 > �� <br /> 3 <br /> e <br /> z <br /> m <br /> A <br /> m <br />