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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 />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 (C1 & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & I1) $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 />1 $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: K-0 d h <br />Property Owner's Mailing Address: l j � ( h 1-(J'.L0( <br />City State Zip <br />Property Site Address: $ aZ gF4t1 <br />Contact's Telephone Number: S I" ;L 3 8" 6 5 t r o <br />Contact's Email: r -i 0 to L'. (@ It � l y� t o <br />Legal Description of Property: S E t att q A 4c' ,, <br />Section #: Z S Town #: YO N Range W Town of: (1 I 07n J <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 />/" ,Ar. <br />2Sb S <br />e, A <br />//// (Home/Cabin; Commercial Business; Bedroom; D k; /etc.)) // <br />Building Contractor: Av.9,Wtr•Soni Sewer Installer: �a �t /7 v 1510 G/J'l <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:—? -2o " 17 In' gals o sit i ' staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: 9- 2D - / 7 <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />x <br />c� <br />Fee Rec-300r Cc <br />En <br />CA <br />d <br />M <br />°z 0 <br />W Z m <br />0 N <br />V O <br />C�9 Z <br />< L7 U <br />M <br />H <br />b <br />x <br />r� <br />z <br />rn <br />