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LAND USE PERMIT APPLICATION- Burnett County WI 7 c <br /> b <br /> Applicant Complete All Sections Below This Line 0' G v <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> c <br /> O <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 �77 ~ <br /> M <br /> Addition to Ace.Structure $150 Addition to Accessory Structure-Commercial(C1 &11) $200 �. <br /> Accessory Structure-Commercial(Cl &11) $200 Gazebo(WI Stat 59.692(lv)) $350 0 , <br /> Deck/Stairs atio/Retaining WaIUSidewatk/Driveway& Filling/Gradmg $150 <br /> Campground Screen Porches $125 Boathouse - <br /> $500 d' <br /> Camping Unit(Six Months Year) $100 � <br /> m <br /> Permit Extension(Valid for one year-Only I Allowed) $100 _ <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 application form,see corresponding application and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> n <br /> Property Owner's Name: t O� Q`M i��/ T'J S 3 <br /> yy C N kit <br /> Property Owner's Mailing Address:DA � o _<4 �i J `L `� / J V JD -S <br /> Property Site Address: �� <br /> S u City State Zip p <br /> �(Contact's Telephone Number: 2 LT (V 9 fo <br /> Contact's Email: <br /> g P prtY �� <br /> Legal Description of Prope <br /> Section#: Town#: N Range#: W Town of: <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): s —1 <br /> Proposed Use of Structure/Addition:_Sj�Or6zd\� <br /> Anticipated Start Datta: (^ �,(H <br /> ome/Cabin;Commercial Business;Bedroom;Deck;etc.) (� 91 <br /> Building Contractor: &!-eV Sewer Installer: z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIO LISTXD BELOW: <br /> V\ 0.� ars 6,i � �nt5 �I1I ( n <br /> Fee Rec: S 01,60 <br /> N LQ i) ��Ctv \_ <br /> t 1 <br /> m j 5T vn 131 s, de:_ se. 6_T, <br /> Date of staff site visit: — — Initi Is of site 'sit staff: <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 1/2017 <br />