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r <br />RYA <br />LAND USE PERMIT APPLICATION - Burnett County, WI <br />All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building - Single Family <br />$300 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Commercial/Industrial Building <br />$300 <br />Accessory Struucture(Non-Bunkhouse) <br />$150 <br />Bunkhouse <br />$250 <br />Accessory Structure -Commercial (Cl & I1) <br />$200 <br />Wall/Sidewalk/Driveway & <br />•ound Structures $125 <br />g Unit (Six Months Per Year) $100 <br />Extension (Valid for one year - Only 1 Allowed) 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 />*items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: (1 6'C'r'.; L { J- d �w 'e, , FD c'� � St�� L i ✓ � ^j /' ,4 <br />Property Owner's Mailing Address: � %� �('�/�,i.% � F,—i- / Ir. ���r�¢� <br />City State Zip <br />Property Site Address: 024 ,5a � n 4)a:,\ I ��/�%1jS%: `�a-Lri 52/6 <br />Contact's Telephone Number: <br />� <br />Contact's Email:1 w C °L i w`1 S 0 rl Gi r v l.0 S <br />Legal Description of Property: 1'`( I— /%) 6-1,) 1) �-e7l Jc ( 1- 0 f <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): 9 ,3 7 11 <br />Proposed Use of Structure/Addition: Oc L k b r <br />Anticipated Start Date: 'rrni4 _C4L4,,t4Home1Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor:i t n,1 %ii Sewer Installer: 1 1 � <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: Initials of site visit staff: <br />4 PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />� <br />\b <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />l <br />Addition to Commercial/Industrial Building <br />$200 <br />Addition to Accessory Structure <br />$150 <br />Structural Alteration to Accessory Structure <br />$150 <br />Addition to Accessory Structure -Commercial (C1 & I1) <br />$200 <br />n <br />A <br />Cn <br />Gazebo (WI Stat 59.692(lv)) <br />$350 <br />< <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />a <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: (1 6'C'r'.; L { J- d �w 'e, , FD c'� � St�� L i ✓ � ^j /' ,4 <br />Property Owner's Mailing Address: � %� �('�/�,i.% � F,—i- / Ir. ���r�¢� <br />City State Zip <br />Property Site Address: 024 ,5a � n 4)a:,\ I ��/�%1jS%: `�a-Lri 52/6 <br />Contact's Telephone Number: <br />� <br />Contact's Email:1 w C °L i w`1 S 0 rl Gi r v l.0 S <br />Legal Description of Property: 1'`( I— /%) 6-1,) 1) �-e7l Jc ( 1- 0 f <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): 9 ,3 7 11 <br />Proposed Use of Structure/Addition: Oc L k b r <br />Anticipated Start Date: 'rrni4 _C4L4,,t4Home1Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor:i t n,1 %ii Sewer Installer: 1 1 � <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: Initials of site visit staff: <br />4 PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />01 <br />Fee Rec: J �� <br />0 <br />m <br />O <br />zM <br />z <br />C) <br />m <br />M M <br />ZZ :4t --i <br />- 20 C-rI <br />'I'Do cc <br />000 <br />b <br />s <br />r� <br />r� <br />� <br />\b <br />a <br />d <br />C <br />CD <br />M <br />o <br />n <br />A <br />Cn <br />< <br />Cr <br />? <br />a <br />� <br />0 r <br />o <br />r <br />� <br />z <br />0 <br />01 <br />Fee Rec: J �� <br />0 <br />m <br />O <br />zM <br />z <br />C) <br />m <br />M M <br />ZZ :4t --i <br />- 20 C-rI <br />'I'Do cc <br />000 <br />b <br />s <br />r� <br />r� <br />