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LAND USE PERMIT APPLICATION — Burnett County, WI <br />A»»Ii�attt C`iinl�tF All Cprtnne R�lnw This Tina <br />Permit Types and Fees: (Check appropriate box boxes) <br />; <br />Dwelling/Principal Building- Single Family <br />$300 <br />Addition to Dwelling/Principal Building- Single Family $200 <br />DNelling/Principal Building- Multi -Family <br />$300 <br />Structural Alteration to DmIling/Principal Buildings $200 <br />Z <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 & I1) $200 <br />Deck/St airs/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 11 <br />Boathouse $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />$100 11 <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 />and J Thoemke <br />Property Owner's Mailing Address: 14477 Bistram Road, Gra <br />Property Site Address: <br />Contact's Telephone Number: <br />Contact's Email: <br />Same <br />WI 54840 <br />City State Zip <br />Legal Description of Property: <br />Section #: 33 Town #: 39 N Range #: 19 W Town of: West Marshland <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): 28066 <br />Proposed Use of Structure/Addition <br />Anticipated Start Date: <br />New manufactured home 2 -BR <br />(Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: Sewer Installer: Ross Tollander <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />�yv) vv�r) <br />f r kz /)% <br />m , � �o'We /6we, <br />ga, <br />Date of staff site visit: p - 3 1 - / 7I iti is of 'te A it staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: - 17 <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />111 <br />i �_ <br />b r <br />b <br />C J <br />d <br />V n <br />S <br />A <br />0 <br />0 <br />CD <br />n <br />o' <br />z <br />0 <br />n <br />07 <br />o � <br />TAI J <br />G <br />fD <br />b <br />b <br />tro <br />1 <br />Cn <br />0 <br />z <br />Fee Rec: 3o o D <br />I <br />'��5 �� <br />�M <br />Fri <br />z20 <br />0® <br />o <br />Z <br />uuu <br />