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LAND USE PERMIT APPLICATION - Burnett County, WI a <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building - Single Family <br />$300 <br />Addition to Dwelling/Principal Building - Single Family $200 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />Accessory Struct ure(Non-Bunkho use) <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (C1 & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (CI & Il) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(lv)) $350 <br />Filling/Grading $150 <br />Camping Unit (Six Months Per Year) <br />$100 <br />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 />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: <br />Property Site Address: <br />0 7, v` D , z4>e <br />Contact's Telephone Number: a-3-224 42�0 <br />)no <br />,F- <br />City State Zip <br />Contact's Email: /If c,V,17 %Je Muf�jo7"lyJ�,�I, zz� <br />Legal Description of Property: <br />Section #: Zo Town #:_J�N Range _�W Town of: 0,6;A 1�t <br />*Attach additionalpage if neededfor 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): /3 %� <br />Proposed Use of Structure/ <br />Anticipated Start Date:_ f <br />Building Contractor: <br />(Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Sewer Installer: <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: � <br />rc�w,e 4 G a r\A41,3n5 <br />Initials of site visit staff: S15 <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE)�raS_ <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />III <br />°o <br />0 <br />w <br />5 <br />C" <br />b <br />Fee Rec: _ <br />^o <br />Z <br />