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LAND USE PERMIT APPLICATION - Burnett County, WI a ro <br /> y ^ � <br /> Applicant Complete All Sections Below This Line 0 v <br /> Permit Types and Fees:(Check appropriate box/boxes) ° <br /> Dwelling/Principal Building-Single Family $300 WAddition to Dwelling/Principal Building-Single Family X200 \ <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 I <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 ~ <br /> G] ` <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <_ <br /> Accessory Structure-Commercial(Cl&II) 1$200 Addition to Accessory Structure-Commercial(CI &I1) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 w <br /> Campground Structures $125 Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> 'u <br /> m <br /> Permit Extension(Valid for one year-Only 1 Allowed)1$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 application form,see corresponding application and fees. <br /> *ltems not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. $ <br /> ire S rA <br /> Property Owner's Name: 1'Y) A(Z t,` I�R�� W N E K V�l ` N = <br /> ` < z <br /> Property Owner's Mailing Address: 3-731 U DUGI A➢,�D TQa; {{--�C A AVv Yn N 5 5,23 <br /> y o <br /> 1 City State Zip o <br /> Property Site Address: D �G TDtUVIJ°�lf�QeV.�Dr� we- S IvT__eA <br /> Contact's Telephone <br /> a�z�n�ERs�� �►s-sc- -2�3s o <br /> Number: <br /> r ?. <br /> Contact's Email: b t-ga , Pete rs/o► N wi ��7,G5m-P A i� yc a &1 <br /> C-S d <br /> Legal Description of Property: (n 9 55 q 1y t G , -1 / <br /> Section#: 6 Town#: �N Range#:� �7 W Town o£ fy) e e'IU G V <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> I <br /> Tax ID#(1-5 digit number;found on tax statement): �j Z{ (a s \ -1 <br /> Proposed Use of Structure/ ddition: SM J3) �I:�i WI <br /> Anticipated Start Date: DI I O l F7 (Nome/Cabin;Commercial Business; edroom;Deck;etc.) <br /> n <br /> Building Contractor: ?e-te 6ok s Sewer Installer: z <br /> y � <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/COND1'1IONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec•� <br /> y <br /> O <br /> °z C <br /> n M <br /> y Z O <br /> Date of staff site visit: _ Initials of site visit staff <br /> °z Z <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: � Z <br /> ® N <br /> 0 <br /> Page 1 of 3 c <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> b <br /> m <br /> z <br /> m <br />