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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line r v <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> d W <br /> Dwelling/Principal Building'Single Family $300 1 Addition to Dwelling/Principal Building'Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 O <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> G1 d <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(lv)) $350 <br /> Campground Structures $125 Filling/Grading $150 -36 <br /> ? <br /> w <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 b <br /> m <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 5. <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. Q^r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> � < <br /> Property <br /> L� <br /> Owner shame: /,L� / o � <br /> ProP <br /> Property Owner's Mailing Address: G3 � t /V ` a4-1ahw l,�Ilv -may a �l <br /> City State Zip o <br /> Property Site Address: <br /> Contact's Telephone Number: Sw-A o 1 <br /> Contact's Email: VC¢i/r;•C OM <br /> d <br /> Legal Description ofPropertylasS 4414 Arts 7-43a'j•�//�/5-/IS5-/5--dq3� <br /> Section Town#: y/ N Range#: /-rW Town of: �Lu�yg oa4aoc v <br /> H I <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: r <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , <br /> C1 <br /> Building Contractor: Sewer 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 /> 1 <br /> 1 <br /> 11 l 1 r <br /> J _1C�1 �O t 1E 7 cStYlcl 5 V�c� e Fee Rec: oW <br /> nn -� <br /> m <br /> s <br /> n M <br /> Date of staff site visit: `�D ' itial of site v' staff. Z �N m <br /> O <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: '�� "/ zZ C) o <br /> aG) O iv <br /> M C o <br /> m Z <br /> Page 3 <br /> 0 0 <br /> Burnett County,WI Land Use Application—Rev 03/2/2017 <br /> m <br /> a <br /> m <br />