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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />ermit 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- Bunkhouse) <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (Cl & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & 11) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(1 v)) $350 <br />Filling/Grading <br />Camping Unit (Six Months Per Year) <br />$100 <br />Boathouse q$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: 1V_JU ILW I^- i <br />Property Owner's Mailing Address: " 1j 5 <br />Property Site Address: n6 al Ca i <br />City <br />Contact's Telephone Number: <br />Contact's <br />Legal Description of Property: <br />r M <br />Section #: Town #: N Range #: W Town of: <br />Zip <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: Glom e" _ '9L- 04e ---x3,—, <br />Anticipated Start Date: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: 1,a1a 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 />6y \) ' )c,c. _ �GI r,_, <br />GY>S V (—C 6— S c_ <br />It <br />A� <br /><_3 <br />Date of staff site visit: Ini als of site visit staff: ) / r <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: r o _ 1 <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />Fee Rec: 3 OQ <br />