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LAND USE PERMIT APPLICATION — Burnett County, WI r <br />a 9 <br /><' b <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Princi a] Building- Single Family $300 Addition to Dwelling/Principal Building- Single Family $200 <br />co <br />Dwelling/Principal Building - Multi -Family $300 !Structural Alteration to Dwelling Principal Buildings $200 <br />Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br />Accessory Struct ure(Non-Bunkho use) $150 'Addition to Accessory Structure $150 <br />Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (Cl & I1) $200 Addition to Accessory Structure -Commercial (CI & I1) $200 0 <br />Deck/Stairs/Patio/Retaining WalYSidewalk/Driveway & Gazebo (WI Stat 59.692(lv)) $350 <br />Campground Structures $125 Filling/Grading $150 <br />m <br />Camping Unit (Six Months Per Year) $100 Boathouse $500 "a <br />Permit Extension (Valid for one year - Only I Allowed) $100 <br />z <br />*NOTE: After -the -fact (when no permit is obtained prior to construction) is up to three times the normal fee. ° 1 <br />*Communication Towers & Signs require a different application form, see corresponding application and ees. <br />o <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />m n <br />Property Owner's Name: C 1c_�v' C,q C r z <br />2. <br />Property Owner's Mailing Address: <br />City State Zip d <br />Property Site Address: <br />Contact's Telephone Number: 710 -�2 -��E� S' 1 -7/ S � 3 2-0 <br />a o� <br />Contact's Email: 1'6 11 crt` UJ 31 cid LEL' r <br />r <br />Legal Description of Property: <br />Section #: ' Town #: _-N Range # �l 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.* i <br />Tax ID # (1-5 digit number; found on tax /statement): <br />Proposed Use of Structure/Addition: L6Jb'►V1 -s'/ I ��� C . Y > `4 �} <br />Anticipated Start Date: 04_4__A_[�' (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) C� <br />Building Contractor: Sewer Installer: z - <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY -. <br />THIS PERMIT IS SUBJECTTO ALL CONDITIONS LISTED BELOW: <:> <br />t <br />j� Yl C <br />Fee Rec:<3 <br />v <br />c <br />m <br />t ✓Fffl' <br />Date of staff site visit: Initials of site visit staff : O 2', Z C= <br />NM C <br />PERMIT APPROVED BY ZONING OFFICIAL: 20/_ DATE: `� 'z bz rF�l'r` <br />n 6 o <br />Page 1 of 3 Z <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />x <br />