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LAND USE PERMIT APPLICATION - Burnett County, WI <br />Applicant Com Tete 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 (Cl & 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 />Gazebo (WI Stat 59.692(lv)) $350 <br />Filling/Caading $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: Z-7 S <br />Property Site Address: 5 far M <br />k— <br />IiACoIVN S�- <br />webs e,- v1.r S-yy <br />City State Zip <br />Contact's Telephone Number: -115-`` �`(,L.� Z 3 C4 6 <br />Contact's Email: (- t V "t, C, rC'*'j C oy P 1 1 \0U\ <br />Legal Description of Property: <br />Section #: Town #: 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): J 'I I M / <br />r <br />Proposed Use of Structure/Addition: c EC / D Y 2� <br />Anticipated Start Date: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: <br />Sewer Installer: <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: <br />S V !1- <br />Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />30-1 <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />lid <br />00 <br />0 <br />w <br />5 <br />Fee Rec: lr <br />