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LAND USE PERMIT APPLICATION - Burnett County, WI <br />Applicant Co late All Sections Below This Line <br />emit 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 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 & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & 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: -nom w t-- I e C <br />Property Owner's Mailing /A'ddress: <br />Property Site Address: 1V A <br />Contact's Telephone Number: b7 I D,_ 9 10 <br />Sf /Y\Pj, MN SsgI0 <br />City State Zip <br />Contact's Email: L <br />Legal Description of Property: ��7 SAP\ V cl 6S <br />Section #:�_ Town #: N Range #: W Town of: <br />*Attach additional page if needed for lengthy description OR attach a copy othe deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): C)_% 1 <br />Proposed Use of Structure/Addition:L U� <br />Anticipated Start Date: (Home/Cabin; eommercial Business; Bedroom; Deck; etc.) <br />Building Contractor: <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 />V Lv-16 - 3!�I X14'1' g- -')" � -tea I <br />Date of staff site visit: Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: b l <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />ro r <br />b <br />a {T <br />O <br />E <br />0 <br />CD <br />r � <br />0 <br />z <br />0 <br />Cn b <br />� z <br />2. <br />CD <br />CL <br />b <br />b <br />1 <br />1 <br />rn <br />a <br />a <br />J) <br />z <br />Fee Rec: <br />