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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Annlicant Comnlete 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 />v old <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />N <br />O <br />Commercial/Industrial 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 />Accessory Structure -Commercial (Cl & 11) <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(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 />[C <br />i D s <br />City State Zip <br />ro <br />°o <br />0 <br />m <br />a <br />Contact's Telephone Number: _7/5,&X& -Z#303 Inaw -52-9 J 114-F <br />Contact's Email: a(,&k( QO. !,Dw On <br />Legal Description of Property: Pi —7 ,5to 55 LyANU W 63m g4e 1c i.ti <br />Section #: 20 Town #:__3_1_N Range #:—/&_W Town of: Gmo7-1 <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. * <br />Tax ID # (1-5 digit number; found on tax statement): PA57 7 <br />Proposed Use of Structure/Addition: _��✓�SfQ�Li I'! X -a,� t <br />Anticipated Start Date: (Home/Cabin; C19mmercial Business; Bedroom; Deck, etc.) <br />Building Contractor:A%V";n" SSW /#1 e-, 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: I _ I itials of site visit staff: <br />G _ <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: ' <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />Fee Rec:1�i.� <br />Z�2 �CD <br />Z <br />n M <br />v old <br />O <br />N <br />O <br />Z <br />d <br />a <br />b <br />x <br />m <br />z <br />m <br />