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.p Spa, <br /> LAND USE PERMIT APPLICATION — Burnett County, WI b r <br /> a <br /> H N� <br /> Applicant Complete All Sections Below This Line 5 <br /> a � <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> d <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwulling/Principal Building-Single Family $200 g <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 ~ <br /> L) t <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl &11) $200 Addition to Accessory Structure-Commercial(CI&11) $200 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 y <br /> Campground Structures $125 Filling/Grading $150 � <br /> Camping Unit(Sint Months Per Year) $100 Boathouse $500 �.e <br /> rn <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 <br /> 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> 0 <br /> *Communication Towers&Signs require a different application farm,see corresponding application and fees. o <br /> *Items not luted above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: / �1 rr f,C K d k y n a°s <br /> Property Owner's Mailing Address: 3 1 W/11144vj 0& 4> ///elo/e Hl, <br /> City State Zip rs <br /> p� o <br /> Property Site Address: ;L•7�lO � t ��d!n "IC4 5ree, Gt/1, <br /> Contact's Telephone Number: <br /> Contact's Email: <br /> 1_ v <br /> Legal Description of Property: J 5 <br /> Section#: 323 `Town#: LfQ N Range#: W Town of H <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7 l <br /> Tax ID#(1-5 digit number;found on tax statement): N 7 7 <br /> Proposed Use of Structure/Addition: /�C �✓ A�1 V Tat �tJ� <br /> Anticipated Start Date: dy!Y 2,d/7 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) X <br /> Building Contractor:au/ It* 4U,, Zis Sewer Installer: CU t'y J 4c 1<!5 0A <br /> N <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT T TO ALL CONDITIONS LISTED BELOW: <br /> VY1a.)(`tyy)Vy \ (icy' LoJS C Po\,/s !� p� <br /> II I- Fee Reoc UrW <br /> USS V e L 1 lJ Q�C�vec� n1� <br /> y <br /> O <br /> m <br /> Date of staff site visit: 'I Initials of site visit staff: <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: r[� <br /> Page 1 of 3 ~ <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> o <br /> x <br /> m <br /> a <br /> m <br />