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lu <br />LAND USE PERMIT APPLICATION — Burnett County, WI <br />A«..1:. -+!'.,m 1.+o All Thio T ine <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 />CD <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />-_j <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 />1 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/Stairs/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 <br />Boathouse $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />1 $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 />*Iterzs not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: C <br />Property Owner's Mailing <br />Property Site Address: <br />Contact's Telephone Number: W - tom. <br />F -y--) <br />City State Zip <br />Contact's Email: - U t-v`y V t01 Vt; , Ie r <br />Legal Description of Property: l y 5 �� <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 propertypage. <br />Tax ID # (1-5 digit number; found on tax statement): j s 1e � <br />Proposed Use of StructureStructure/Addition:Anticipated Start Date: A -r-4: ' (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: / t , �? " Sewer Installer: A_A <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: I �— J — f -� Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />x <br />rn <br />n <br />Z <br />M <br />CD <br />-_j <br />Z <br />a <br />3 <br />ro <br />x <br />m <br />