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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> • y. ~ 1 <br /> Applicant Complete All Sections Below This Line 71 r' v <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 /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 1 <br /> Commercial/Industrial Building $300 Addition to CommerciaVlndustrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> G7 t <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl & 11) $200 Addition to Accessory Structure-Commercial(C1&11) $200 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 <br /> Campground Structures $125 Filling/Grading $150 �• <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 �.o <br /> m <br /> Permit Extension(Valid for one year-Only I Allowed) $100 0 <br /> z <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a different applicationform,see corresponding application and ees. =' <br /> o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 6 <br /> Cnn <br /> Property Owner's Name: J b <br /> � <br /> r'1 �� �vt , S+ P,R,vI / M.1j 5��3 0 G <br /> Property Owner's Mailing E a <br /> ` p nn City St toi G <br /> Property Site Address: G� i ��� 0 6 0 1 1 Y� Y t (, c. <br /> 15 -ag 6- a3 ( ' <br /> Contact's Telephone Number:') 16 ��` � � <br /> 5' <br /> Contact's Email: <br /> Legal Description of Property: <br /> Section#: 1 - Town#: 1' � N Range#: IS W Townof: <br /> 'v o <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): `�p v 0 H <br /> Proposed Use of Structure/Addition: 6 a-2\Ot , tz, <br /> Anticipated Start Date: (Home/Cabin;eommercial Business;Bedroom;Deck;etc.) <br /> j� <br /> 1 - � n <br /> Building Contractor: Rwl. W t L'M O A Sewer Installer: U(1A E z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW:1 U' <br /> L v f Y C_,r� v t\O�Mn ��C 15 �S _ Fee Rec:L <br /> y <br /> m <br /> z Q <br /> z <br /> Date of staff site visit Initials of site visit staff: n Z c <br /> L o QM r <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATEQ � Z <br /> G)0 o <br /> Page 1 of 3 0 <br /> Burnett County,WI Land Use Application—Rev 03/2017 > — <br /> 3 <br /> x <br /> m <br /> A <br /> m <br />