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LAND USE PERMIT APPLICATION- Burnett County, WI <br /> 70 <br /> Applicant Complete All Sections Below This Line v <br /> Permit Types and Fees:(Check appropriate box/bores) ii7 <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling Principal Building-Single Family $200 O <br /> Dwelling/Principal Building-Multi-Family $300 11 Structural Alteration to Dwelling/Principal Buildings $200 OVVI <br /> Commercial,Industrial Building $300 Addition to Commercial,Industrial Building $200 j <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 C <br /> C] <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(CI &11) $200 Addition to Accessory Structure-Commercial(Cl & It) $200 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 iv <br /> Campground Structures $125 IFFillingGading $150 <br /> m <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 ` <br /> 9 <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 S <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 applicationform,see corresponding application andfees. 22 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas.landscaping,etc. a. <br /> Property Owner's Name: vit/c( �rI yu,5 1 ) b <br /> z <br /> Property Owner's Mailing Address: HIS/ <br /> Property Site Address: of 9i -3 I ���17��(;�(}ct Cl City StatgM e6o 17 <br /> d <br /> Contact's Telephone Number: 3 a— ?00 <br /> ),�,au <br /> I <br /> Contact's Email: � e!FJ �vI � , t�7(a t uoq'j <br /> Legal Description of Property: 5Q & 4L <br /> Section#: Town#: N Range#: W Town of: (� <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: I. aA <br /> Anticipated Start Date: q—�n�I!—Lao I, ( ome/Cabin,,Commercial Business:Bedroom,,Deck,,etc.) F <br /> Building Contractor: S cwt J Sewer Installer: <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 /> — LSM + Lornb'1ne lows <br /> 4 6 3 ` Fee Rec: <br /> y <br /> m <br /> N <br /> C n <br /> Date of staff site visit: _ J Initials of site visit staff: > 2e �r� <br /> ° r— CJ <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: Z- `-Z Uydn�� o <br /> Page l of 3 mc <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> m <br />