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LAND USE PIERMIT APPLICATION - Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />z <br />?( Dwelling/Principal Structure $300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure $300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 <br />I <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures $125 1 <br />Bunkhouse <br />WI State Statute 59.692(ly) Structures <br />$250 <br />$350 <br />Filling/Grading $150 1 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) $100 1 <br />Permit Extension (1 Year Extension - Allowed Once) <br />$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 />ro <br />Property Owner's Name <br />O s--, f � -. Sljr-- kftolrc— <br />Property Owner's Mailing Address: 2440 <br />Property Site <br />Contact's Telephone Number: j - Go 511 <br />/33 rz S+ W <br />�br.. A2 Web <br />ZZZ - dT,,rb <br />Contact's Email:�I/� tnS a r•-,orc-Q— b qn- C ©.-+-N <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 propertypage. <br />Tax ID # (1-5 digit number; found on tax statement): Co 06 Co <br />Proposed Use of Structure/Addition: / 7 /`^� lC G a — 3 Oe. A4-,o-c`r'\ <br />Anticipated Start Date: ''.S- 1 -!r' -IA (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: rJtn 2 a e>^ Sewer Installer: [.pry �Ge s c:-1 <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />r c�,(-, (nI <br />k\O �k A-0 \ I' �o �, A <br />'� <br />—(� <br />Date of staff site visit: In' ials o ite visit staff: <br />PERMIT APPROVED BY ZONING OFFICIA DATEd— <br />UPON APPROVAL: APPLICAPWMUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 1/2018 <br />0 <br />N <br />5' <br />ao <br />d <br />n� <br />F <br />1� <br />A <br />0 <br />r <br />0 <br />L112 <br />I 111 <br />, ' <br />S <br />0 <br />[`u] <br />z <br />0 <br />0 <br />P <br />Or <br />O\ <br />Ln <br />CD <br />a. <br />CD0 <br />O <br />W <br />0 <br />31 <br />t" <br />b <br />i+ <br />00 <br />r <br />VJ <br />a <br />3 <br />0 <br />'1 <br />fo <br />z <br />� <br />lIt <br />Rec:3 �o,ao <br />�J'Oee <br />d <br />o <br />z <br />n <br />a <br />oN <br />CD <br />o <br />n <br />®' <br />0 <br />ro <br />s <br />m <br />m <br />