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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 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 & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & I1) $200 <br />Dec air atio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />I 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: L , L i,.k� GA ( 6 .-\. it � <br />Property Owner's Mailing Address: 0�'� , l n <br />Property Site Address: �r �r t 6Z v'1. te` <br />City i State Zip <br />Contact's Telephone Number: (O cel.�- <br />Contact's Email: «-.� nLn C-ry <br />Legal Description of Property: t C,, - F -I jj6-L ' I' -( <br />Section #: aTown #: _-_jPi _N Range #:_19___W Town of <br />*Attach additional page if needed for lengthy description OR attach a copy of the da <br />Tax ID # (1-5 digit number; found on tax statement): 1___2 !? <br />attach tax syste--pf operty page. * <br />I LM <br />o° <br />0 <br />m <br />a <br />Tito <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: A...7j e, t `� (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />c • <br />Building Contractor: ).z � � <br />Sewer Installer!``5S � <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THISPERMITIS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />6_4C--(-- ee. 'Nv> <br />US e- <br />\0OVS <br />b- <br />C> >; e,A <br />V5 �8. <br />Date of staff site visit: 1,13 Initials f site visit staff: _/51 y <br />PERMIT APPROVED BY ZONING OFFICIAL• <br />DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />Fee Rec: 3'� .OD <br />