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LAND USE PERMIT APPLICATION — Burnett County, WI a <br />Applicant Com lete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate boxJboxes) <br />Dwellinerincipal Building - Single Family $300 <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />Dwelling/Principal Building - Multi -Family $300 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />Commercial/Industrial Building $300 <br />Addition to Commercial/tndustrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) $150 <br />SAddition to Accessory Structure <br />$150 <br />Bunkhouse $250 <br />;;Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (Cl & Il) $200 <br />Addition to Accessory Structure -Commercial (Cl & Il) <br />$200 <br />Deck/Stairs/Patio/Maining Wall/Sidewalk/Driveway & <br />Campground Structures $125 <br />Gazebo (WI Stat 59.692(lv)) <br />Filling/Grading <br />$350 <br />$150 <br />Camping Unit (Stix Months Per Year) $100 <br />Boathouse <br />$500 <br />Permit Extension (Valid for one year - Only 1 Allowed) $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: <br />Property Owner's Mailing Addres <br />Property Site Address: <br />Contact's Telephone Number: <br />Contact's Email: <br />C .1/-P1 <br />City State Zip <br />Legal Description of Property: I CS #14 Pis() & 1&oeseA 3EA4 <br />Section #:-S2-2,--Town #:_N Range #:j_f_W Town of: <br />*Attach adhhonal 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): 3q(-3'4 <br />Proposed Use of Structure/A ditlon:F,_' /t3 <br />Anticipated Start Date: 7— %s— / -7 j (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: Sewer Installer: <br />AREA BELOW THIS LINEfRESERVED FOR ZONING STAFF COMMENTS/C0NDTFTONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />140 h, �) V A Y-- �C_ e --C, 6k- 113.E C_ I <br />9 —� <br />Date of staff site visit: Initials of site <br />PERMIT APPROVED BY ZONING OFFICIAL: <br />S,(� <br />DATE: 9— 5— ) j <br />Page I of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />0 <br />W <br />d <br />0 <br />