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I <br />LAND USE PERMIT APPLICATION - Burnett County, WI a <br />Applicant Complete 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 />z <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />rV <br />O <br />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />xAccessory <br />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 (C1 & 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/Grading $150 <br />Camping Unit (Six Months Per Year) <br />.$1 00 <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 />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: Fr( I � -70 <br />Property Owner's Mailing Address: -!� <br />Property Site Address:_e6 U r A- <br />Contact's Telephone Number: 61) - 7- 0 � � 7 <br />Contact's Email: <br />1,-41 <br />L,.,v /4)U) f awrs(Y M14/ S530 S <br />City State Zip <br />^ / 1 <br />Legal Description of Property: IV r 1�� / V /� I V <br />Section #: / / Town #: 3 ff N Range #: 7 W Town of. -/6.Y�'1~LS <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): l Q <br />oq v <br />Proposed Use of Structure/Addition: ,S r 1 e 6L — e 01 4z�, <br />Anticipated Start Date: AT f (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: 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 />N2VeC � O �e USe�. �'r hvm�� <br />O LLu a.y­�c-• S �� �;��L�11 <br />r'n vs} <br />Date of staff site visit: ' _ / Inis of site v' it staff: <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />Fee RecJUIX <br />Ln <br />d <br />m <br />O <br />a <br />z <br />m <br />-< <br />h <br />�J <br />rV <br />O <br />d Z <br />a <br />b <br />z <br />M <br />rn <br />M <br />