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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 />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 />l <br />Commercial/lndustrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />j <br />Accessory Structure -Commercial (Cl & 11) <br />$200 <br />1 Addition to Accessory Structure -Commercial (Cl & 11) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (Wl Stat 59.692(lv)) $350 <br />Filling/Grading $150 <br />Camping Unit (Six Months Per Year) <br />$100 <br />1 Boathouse $500 <br />Permit Extension ( Valid for one year - Only l 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: t"l `�V washby n Aye_ _(4 �'/�fl� f'/�i� Z�iV <br />City T State Zip <br />Property Site Address:�j �� (" <br />Contact's Telephone Number: (D7 I — <br />Contact's Email: <br />Legal Description of Property: -� <br />Section #: Town #: <br />N Range #: W Town of: <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: <br />Anticipated Start Date: <br />Building Contractor:_ <br />Business; Bedroom; Deck; etc.) <br />Sewer Installer: <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: I itials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIA / DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />b r <br />ro <br />d <br />v <br />rn <br />O <br />a <br />0 <br />r <br />0 <br />a <br />b - <br />t <br />0 <br />z <br />0 <br />n <br />� z <br />C, <br />b Su <br />as <br />y t <br />0 <br />y � <br />l <br />Z <br />Fee Rec: sb+ 00 <br />Z <br />M <br />m <br />I <br />0 <br />0C=) <br />s---� <br />Z <br />�' ln�ir <br />