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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Annli�ant f mm�lete A11 Sertirinc Re1cr, Th c Line <br />Permit Types and Fees: (Check appropriate box boxes) <br />Dwelling/Principal Building - Single Family <br />$300 <br />Addition to DwellingfPrincipal Building - Single Family $200 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />y <br />r <br />Comm ercial/Industrial Building <br />$300 lAddition to Commercial/Industrial Building $200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 <br />jAddition 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 (CI & 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 />$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 <br />Property Owner's Mailing Address: <br />Property Site <br />�;n 0-4t'1s fin+" <br />(055 &g6f'4 Ave ge-IcLensr' Ile-, 'WRI 54003 <br />-7635 R%1JL_ <br />Contact's Telephone Number: _115- ]WE 3907 <br />Contact's Email: .3 txSTi n %et15 iu-n+ 1 t.0� . Co M <br />Legal Description of Property: �&+ i o� Bij yzitoo (EsWe5 <br />Section #:_ Town #: t4 C) N Range #:_� W Town of: W 005+1r C <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 />Building Contractor: <br />(Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Sewer Installer: <br />THIS PERMIT IS SUBJECT TO iA__LL CONDITION�S LISTED BELOW: } j� <br />J <br />Date of staff site visit: Initials of site visit staf <br />PERMIT APPROVED BY ZONING OFFICIALADATE <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />D <br />J <br />i <br />2. <br />Z <br />2 <br />Fee Rec: M, uo <br />Z <br />D <br />{ <br />y <br />r <br />Z �'�0- <br />