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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 />$300Addition <br />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 Struct ure(Non- Bunkho use) <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (CI & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & I1) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Crazebo (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: <br />Property Owner's Mailing Address: <br />City State <br />Property Site Address: <br />Contact's Telephone Number: 161 a 4pa— 1 *'13'7 <br />Contact's Email: ® 9 ftp A . UrM <br />Legal Description of Property: t4LY &7_CJ,5� (oil NW SW k X tLy ,;j j7 � <br />Section #:_Town #:�9 N Range #:�_W Town of: <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): 1168.3 <br />Proposed Use of Structure/Addition: 11 i VVie' tMU <br />Anticipated Start Date: (Ho e/Cab ; Commercial Business; Bedroom; Deck,, etc.) <br />Building Contractor: Installer: <br />—r - <br />OR, ZONING SjAjLF COMMENTS/CQNRITIO_NS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: I 1 — 14 / 7 Initials of site visit staff: ­5� D-8 <br />PERMIT APPROVED BY ZONING OFFICIAL: I DATE:])— /b12 <br />.;;w_ lu <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />a <br />y <br />s� <br />171 <br />m <br />5 <br />W <br />m <br />r <br />O <br />E <br />f <br />Fee Rec: <br />