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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Annficant Com lete 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 />Structtual Alteration to Dwelling/Principal Buildings $200 <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 & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & Il) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(1,)) $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 />ISI00 <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: /a(,4 % Y '-' <br />Property Site <br />Contact's Telephone Number: 65/ "28'1 ?91 <br />Contact's Email: Mn o lye s aD InSA . Com <br />Legal Description of Property: <br />-d lane lvkJ El <br />Section #: ?3 Town #: 39 N Range #: <br />__LS- W Town of LA Fo <br />5.$330 <br />Zip <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): l o,2S % <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: & —// % ft S/:i'P (Home/Cabin; Commercial Business; Bedroom; Deck. etc) <br />Building Contractor: ,SG(- B /+ Sewer Installer:dop king Qe4 ,r- 4 <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: 4 9 ^' � Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIALS %-,/_ _ DATE: I <br />Pagel of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />S- <br />ITI <br />°o <br />b <br />N <br />0 <br />5' <br />d <br />n <br />Fee Rec: <br />b <br />J <br />