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LAND USE PERMIT APPLICATION — Burnett County, WI crr <br /> c b r <br /> N ^ • <br /> Applicant Complete All Sections Below This Line 0' 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 O <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 l <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <_ <br /> Accessory Structure-Commercial(Cl &11) $200 Addition to Accessory Structure-Commercial(CI &11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Sat 59.692(lv)) $350 <br /> Campground Structures $125 Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 �y <br /> ° <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. o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: L ,i" 1 o S •t i 4 z <br /> _ W Cn <br /> Property Owner's Mailing Address: I .PJM C L 0 � to Waita W I a <br /> city State Zi o <br /> Property Site Address: Q. <br /> I <br /> Contact's Telephone Number: f - SlPlp- // 73 <br /> 5' <br /> as <br /> Contact's Email: t7 <br /> m' <br /> 7. <br /> Legal Description of Property: <br /> Section#: 5 f g Town _PI#ZN Range#:&1�W Town of:� j y 1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ' 5 l <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> y <br /> Proposed Use of Structure/Addition: S/ p <br /> Anticipated Start Date:`,�Si? / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) F i <br /> Building Contractor: �/e0 n-/T Sewer Installer: � A z <br /> N <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec: <br /> N <br /> _N <br /> d <br /> m <br /> N <br /> C1 <br /> - � � IZ <br /> Date of staff site visit: Initials of site visit staff: <br /> PERMIT APPROVED BY ZONING OFFICIAL: �j DATE- zo N <br /> j <br /> Page 1 of 3 o ti <br /> Burnett County, WI Land Use Application—Rev 03/2017 <br /> 3 <br /> 9 <br /> S <br /> m <br /> F <br /> M <br />