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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 />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />AAccessory <br />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 (C1 & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & 11) $200 <br />Deck/Stairs/Patio/Retaining WalUSidewalk/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 />State <br />Property Site Address: <br />Contact's Telephone Number: -1157. 962p .,V -S J:3 M5?ni-N%- <br />Contact's Email: A phy4 (�&�*06 • Llllil�l <br />Legal Description of Property: G�a� ✓�q p/ 5 35j{57) 6ffF /45) <br />\ Section #: 29 Town #: N Range #: /6-0 W Town of. A*foojf i <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): 4.7-1,53 <br />3 <br />Proposed Use of Structure/Addition: [�/C.Q-Vf � C>m <br />Anticipated Start Date: �,,��� �— (Home/( <br />Building Contractor: 6 ��[.� 1('QAskv /#I& <br />X a.1 <br />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 />0 1.,7 <br />Date of staff site visit: R-30-11 nitials f si t staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE:��_ <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />0 <br />0 <br />0 <br />m <br />5 <br />r <br />b <br />i <br />I� <br />i <br />Fee Rec:G <br />77 <br />0 <br />N <br />O <br />z <br />W <br />S <br />M <br />