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Jlf LAND USE PERMIT APPLICATION - Burnett County, WI a _ b <br /> y ^ 1 <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Check appropriate box boxes) ° <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 \ <br /> Dwelhng/Prmcipa)Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 ���`�0 <br /> O <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 \ <br /> 0 <br /> 0 <br /> Addition to Ace.Structure $150 Addition to Accessory Structure-Commercial(CI &11) $200 <- <br /> Accessory Structure-Commercial(Cl &11) $200 Gazebo(WI Stat 59.692(]v)) $350 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Filling/Grading $150 w <br /> Campground Screen Porches $125 Boathouse $500 d' <br /> Camping Unit(Six Months/Year) $100 .a <br /> ro <br /> Permit Extension(Valid for one year-Only 1 Allowed)1$100 <br /> ENTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> mmunicationTowers&Signs require a different applicationform,see corresponding application and fees. <br /> s not listed above will be treated as accessory structures,such as:pergolas, <br /> /landscaping,etc. / <br /> Property Owner's Name: V I t✓ �Q�`�Q✓ lU�/ Y �S L� z <br /> Property Owner's Mailing Address: Citn� ,�y <br /> Property Site Address: 7(Q O� z'2 `�'^� /��lz � y `p <br /> � Sta <br /> Contact's Telephone Number: /S� p p�` 7913 <br /> N w <br /> 0 <br /> Contact's Email: t 2 <br /> 1 ✓� Thi/�Cr '��Sc�G �f� �2 <br /> Legal Description of Property:_ <br /> Section#: Town#: Town Ran Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy <br /> �o>f the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax state /ment): / / 1 <br /> Proposed Use of Structure/Addition: Cpm o'n A b e"v,, 4JI-_6 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: r z <br /> G <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> TIII PE IT IS SUBJEC TO ALL CO DITIONS LISTED BELOW: <br /> 14 Fee Rec: R1 10 <br /> W <br /> 33 <br /> 33 <br /> Z o <br /> Date of staff site visit: a 1 Initials of site visi staff: 5 Q `�Q � ago <br /> 20 <br /> I� b a C� <br /> PERMIT APPROVED BY ZONING OFFICIALZ DATE: SO <br /> ' 1 C Q <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 10/2016 <br />