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LAND USE PERMIT APPLICATION - Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br />Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br />Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension - Allowed Once) $100 <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost 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: A M C 5 rj A S 5 <br />Property Owner's Mailing Address: Z `f � i � b�" LN Nw A,,G6)f-r µN SS 30� <br />City State Zip <br />Property Site Address: C (7�Jn'�-�( <br />Contact's Telephone Number: �, Z , 0 V Zs� <br />Contact's Email: --Sc ClSS� "" a'kcu'w� <br />�x s <br />Legal Descriptionod i- or to <br />- of Property: � 32� <br />Section #: Town #: L{ D N Range #: I Sr 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): .S 3 Z <br />Proposed Use of Structure/Addition: H ^ Seg ) X bC) <br />Anticipated Start Date: DI (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 N SUBJECT TO ALL CONDITIONS1`LISTED BELOW: <br />, Q arA" r -s <br />J <br />tld jer <br />Date of staff site visit: ^ �' O Is of site sit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL:I ti —DATE:1- <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />SIGNED 'PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />APPRU'ftVED Burnett County, WI Land Use Application —Rev 1/2018 <br />C <br />Cr <br />a <br />s� <br />Ed <br />r <br />C <br />b <br />21 <br />kA <br />N <br />5' <br />0 <br />G <br />Fee Rec: ISO <br />d <br />N <br />0 <br />z <br />z <br />y <br />a <br />N )> <br />00 <br />m <br />