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LAND USE PERMIT APPLICATION—Burnett County, WI P _ <br /> a <br /> Applicant Complete All Sections Below This Line g' v <br /> Permit Types and Fees:(Check appropriate box/boxes) }� <br /> Dwelling/Principal Building-Single Family $300 11 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 0 <br /> Commercial/Industrial Building $300 Addition to Commercial/Inthstrial Building $200 ,I <br /> Accessory Structme(Non-Bunkhouse) $150 Addition to Accessory Structure $150 . <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 .. <br /> Accessory Structure-Commercial(Cl&I1) $200 Addition to Accessory Structure-Commercial(Cl &il) $200 <br /> Deck/Stairs/Patio/Retaining WaIVSidewalk/Driveway& Combo(WI Stat 59.692(lv)) $350 r <br /> Campground Structures $125 Filling/Grading $150 �- <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> ^v <br /> Permit Extension(Valid for one year-Only 1 Allowed) 5100 <br /> z <br /> *NOTE After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> rent applicationform,see corresponding application andfees.*Communication Towers&Signs require a diB¢ <br /> pp <br /> *Items not listed above will be treated as accessory structures,such as:pergolus,landscaping,etc. a <br /> Property Owner's Name: Wr &4 m ANd /Li'L/�j ,p p(.IF LT trX10 < <br /> Property Owner's Mailing Address: G ! _ �- _ a <br /> City State Zip v G <br /> Property Site Address: 27,097 fima S404? �)� A e=—TF. / SU <br /> Contact's Telephone Number: /,(S` 210 - �.Z,3�e o <br /> o I <br /> Contact's Email: f/j ,(gyp/aJ G2 /'e/YIl_'ASt 4ZA f o 1 <br /> X07` y'/ GS/A OoL YS-1 9 "R 7 up <br /> Legal Description of Property: d jjr 40r 2� �i�AIE <br /> Section#: 2+y Town#:_*�_N Range#:_JS- W Town of: <br /> o I <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage.* 1 <br /> Tax ID#(1-5 digit number;found on tax statement): S"BS D r r�YtT -i <br /> Proposed Use of Structure/Addition: b h I e _L ` A . dWh aur r <br /> Anticipated Start Date: —T� (Home Cabin;Commercial Business;Bed m:Deck;etc.) ) <br /> Building Contractor: tl ! ' t Sewer Installer: y z <br /> N <br /> AREA BELOW THIS LINE RESERVE FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec:4/0 0 <br /> N <br /> h_ <br /> t7 <br /> M <br /> N <br /> Date of staff site visit: Ini als of site visit staff: o N Z D u <br /> PERMIT APPROVED BY ZONING OFFIC DATE: _ 0 <br /> " N <br /> C) <br /> 0 <br /> Page 1 of 3 C <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> i» <br />