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LAND USE PERMIT APPLICATION- Burnett County, WI C <br /> _ b <br /> Applicant Complete All Sections Below This Line 4 <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> a <br /> d <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <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 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> M <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl &Il) $200 Addition to Accessory Structure-Commercial(CI &11) $200 c <br /> Deck/Stahv?atio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(l v)) $350 w <br /> CampgroundStructu¢es $125 Filling/Grading $150 <br /> m^ <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> v <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 <br /> z (6 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three rimes the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. c <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o �( <br /> t� L m n <br /> Property Owner's Name: <br /> O y � <br /> Property Owner's Mailing Address: Q R Izo 3 f?�.arah Q r W'.e 6.egeer. 5"%3 2. <br /> City State Zip tv <br /> Property Site Address: 2ae2c:d Rte• LAI--t a-(• 9j <br /> Contact's Telephone Number: b(Z- `t(9- as" o � <br /> 5' <br /> Contact's Email: rw'c1 . CC,V6% o <br /> N <br /> Legal Description of Property:Y� ' � G3M 137 = K)I <br /> Section#: Town#: N Range#: W Town of: rn <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* \ o <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: C.Ob ti b.,OVA <br /> Anticipated Start Date: Apm I I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> � I <br /> Building Contractor: QdSe-% qLb e.,,-L- Sewer Installer: ti z <br /> y <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY 90 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I <br /> �, � • � 15 °% � I /fir1 <br /> Fee Rec:�M•0 <br /> `z C <br /> f n Z <br /> Date of staff site visit: �I - , Initials of site visit staff: � Z (� <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: �O w <br /> m C: o <br /> Page 1 of 3 o It It U <br /> Burnett County, WI Land Use Application—Rev 03/2017 U <br /> 3 <br /> o <br /> x <br /> m <br /> a <br /> M <br />