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LAND USE PERMIT APPLICATION — Burnett County, WI a <br />E� <br />m <br />N <br />Z° <br />Applicant Complete All Sections Below This Line <br />n <br />a <br />Permit Types and Fees: (Check a ro riate box/boxes) <br />Addition to Dwelling/Principal Building - Single Family $200 <br />10 <br />7Dwelling/PrincipaI Building - Multi -Family $300 Structural Alteration to Dwelling/Principal Buildings $200 <br />Z <br />Commercial/Industrial Building <br />$300 Addition to Commercial/Industrial Building $200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 Addition to Accessory Structure $150 <br />Qj <br />Bunkhouse <br />$250 Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (C1 & I1) <br />$200 Addition to Accessory Structure -Commercial (Cl & 11) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Gazebo (WI Stat 59.692(lv)) $350 <br />$125 IF Filling/Grading $150 <br />Campground Structures <br />Camping Unit (Six Months Per Year) <br />$100 Boathouse $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />$100 <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 />o <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />a <br />Property Owner's Name: 1✓.�t�����s. ���. L.(_ C. <br />�. <br />Property Owner's Mailing Address: , -i K IbLi t` <br />1APJ-ACy( a- - 1' 1 T MT)!) <br />I-/3 tv k^ City State Zip <br />Property Site Address: i ) ni A iv 1 A Iv 1 A-, D?R A 1 � 'L i 1 '' �' <br />Contact's Telephone Number: 9,-,n ,r9L1 �5— <br />Contact's Email: �(���. CJ�t1�L?I�1hG.§�IR'�1t�/?i11%V%�aYt` h"sl <br />Legal Description of Property: // `` !0) A — '- <br />Section #: Town #: 7� N Range #: �; W Town of 0(t 0q RC1 <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/Addition: Pjake- <br />Anticipated Start Date: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: Sewer Installer: 17�k V1 <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />�� <br />Date of staff site visit: 10 3 '� ^ Initials of site visit staff: Cs -;6 to -,a <br />PERMIT APPROVED BY ZONING OFFICI DATE: <br />�1 !7 <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />N <br />0 <br />71 <br />a <br />C <br />-- O <br />F <br />i CD <br />C <br />C) <br />C �+ <br />0 <br />;v <br />b <br />Z <br />_ o <br />N <br />7r 0 <br />a. <br />CD j <br />d <br />I� <br />oc <br />o <br />F <br />H <br />z <br />Fee Rec,�Go, 0C) <br />E� <br />m <br />N <br />Z° <br />Q <br />n <br />a <br />C:) <br />10 <br />o <br />Z <br />y <br />ro <br />x <br />ce <br />