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LAND USE PERMIT APPLICATION - Burnett County, WI <br />A—lirant ('mmnlP.te Ail Sections Below This Line <br />Legal Description of Property: /-_g'T 5 <br />Section #: Town #:_o _N Range #:_/(a__W Town of: 0Qu l iW D <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):_3 2 o t//P o <br />i <br />Proposed Use of Structure/Addition: S T A� R s, t o L Ak f. (p 2 0-4., �J <br />Anticipated Start Date: -6- Z- ^ (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 />M S� ,me_,' 1O, s2Ike- Sebalks <br />Date of staff site visit: Ini ials of si a 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 />O <br />F <br />c <br />rn <br />W <br />0 <br />0 <br />�� I I 11110Fee Rec: /Z5, <br />d 0 � 2- <br />0 <br />rn <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 <br />$200 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to D)wlling/Principal Buildings <br />$200 <br />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 <br />Addition to Accessory Structure <br />$150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (C1 & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & 11) <br />$200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Gazebo (WI Stat 59.692(lv)) <br />$350 <br />Filling/Grading <br />$150 <br />Campground Structures <br />$125 <br />Camping Unit (Six Months Per Year) <br />$100 <br />Boathouse <br />$500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />$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: it b Z OOIQ6 4!ts <br />A ✓Y i O U S5 ! 5 <br />Property Owner's Mailing Address: / — <br />City State Zip <br />��rr <br />Property Site Address: 2 %2 /0 C0 a&1l1„ A ^3 V/ ; 5W23 <br />Contact's Telephone Number: 6s/ ~ 33 2 — V,� 6 <br />P_ Contact's Email: _ R_ S Qu D6 , 20 lam! l L o• 06 m <br />Legal Description of Property: /-_g'T 5 <br />Section #: Town #:_o _N Range #:_/(a__W Town of: 0Qu l iW D <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):_3 2 o t//P o <br />i <br />Proposed Use of Structure/Addition: S T A� R s, t o L Ak f. (p 2 0-4., �J <br />Anticipated Start Date: -6- Z- ^ (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 />M S� ,me_,' 1O, s2Ike- Sebalks <br />Date of staff site visit: Ini ials of si a 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 />O <br />F <br />c <br />rn <br />W <br />0 <br />0 <br />�� I I 11110Fee Rec: /Z5, <br />d 0 � 2- <br />0 <br />rn <br />