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e , <br /> LAND USE PERMIT APPLICATION— Burnett County, VVI a _ yc� <br /> 1 < V <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Check appropriate bo-x/boxes) a <br /> DweOing/Principal Building-Single Family $300 Addition to D%elling/Principal Building-Single Family $200 \ <br /> DwellingfPrincipal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 O <br /> CommerciaVlndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> n <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 < <br /> Accessory Structure-Commercial(CI &ll) $200 Addition to Accessory Structure-Commercial(CI &11) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 E 1: � <br /> Campground Structures $125 Filling/Gradmg $150 2 <br /> w <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 a <br /> m <br /> Permit Extension(Valid for one year-Only I Allowed) $100 0 <br /> Z <br /> =TEAe-fact(when no permit is obtained prior to construction)is up to three times the normal fee. ° <br /> Towers&Signs require a different applicationform,see corresponding application and jeer. <br /> bove will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: k5 f uz 4' L)s 4 — Z <br /> Property Owner's Mailing Address: tO "?J g <br /> 11 City State Zip G <br /> Property Site Address: -Rnn 1L1Q .J �k� �4 .S,��Drle t r iA3Z �I o <br /> Contact's Telephone Number: '115 - jo��)s <br /> Contact's Email: (t t1lr�, n ' • CA i'►'1 d <br /> Legal Description of Property: <br /> — p4-4: 1 <br /> Section#: [4 Town#: N Range#: W Town of: d <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/Ad ition -na ra Q o <br /> Anticipated Start Date: p (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> 6hawr^ TC,e ; n <br /> Building Contractor: ` Vl Sewer Installer: z <br /> z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1 f � <br /> I <br /> lv)v,J Fee Reo:�_�e t ,�` ` b <br /> � <br /> �J <br /> Jam/ t-J y <br /> f • �� vsE M <br /> sg <br /> Date of staff site visit: _ •tials of site visit taff: <br /> -) tr„ <br /> PERMIT APPROVED BY ZONING OFFICIAL DATE: Q <br /> I <br /> o <br /> Page 1 of 3 c <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> x <br /> m <br /> A <br /> m <br />