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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box boxes) <br />f <br />U _ <br />Dwelling/Principal Building - Single Family $300 <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />1),, ThngTrmcipal Building- Multi -Family $300 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />O <br />Commercial/Industrial Building $300 <br />Addition to Commercial/Industrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) $150 <br />Addition to Accessory Structure <br />$150 <br />Bunkhouse $250 <br />Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (Cl & Il) $200 1 <br />Addition to Accessory Structure -Commercial (CI & 11) <br />$200 <br />Deck/Stairs/Patio/Retaining wall/Sidewalk/Driveway & <br />Campground Structures $125 <br />Gazebo (WI Stat 59.692(lv)) <br />Filling/Grading <br />$350 <br />$150 <br />Camping Unit (Six Months Per Year) IS100 <br />Boathouse <br />$500 <br />Permit Extension (Valid for one year -Only 1 Allowed) $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 />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name:Q��, I p���l�l�l � n�Q ©�' <br />Property Owner's Mailing Address: <br />i City State Zip <br />Property Site Address: <br />Contact's Telephone Number: 15 __7 33 — 0l S�;_ <br />Contact's Email: <br />Legal Description of Property: OtO-M CkOLV /1 Cre,> (.4-r <br />Section #: 310 Town #: q 1 N Range #: t-) W Town of: <br />*,Vtach 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): ZZtJ-14 <br />Proposed Use of Structure/Agdition: hrtfwalRva- It, — 3 <br />Anticipated Start Date: 10 (Home/Cabin; Commercial Business; Bedroom, Deck; etc.) <br />Building Contractor: 'I 1 i�� Sewer Installer: AIA <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: Initials of site visit staff: <br />Iv-a.S l7 <br />PERMIT APPROVED BV ZONING OFFICIAL: DATE: <br />Pagel of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />23 <br />1 <br />Ji <br />r <br />rn <br />v <br />as <br />f <br />U _ <br />t <br />I <br />l <br />z <br />O <br />0 <br />Fee Rec: <br />x <br />e <br />m <br />N <br />0 <br />z <br />z <br />0 <br />a <br />0 <br />NMr <br />Q <br />ZI <br />o }0 <br />K Z <br />m <br />