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LAND USE PERMIT APPLICATION — Burnett County, WI <br />ADDlicant Comnlete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building- Single Family $300 1 <br />Addition to Dwelling/Principal Building- Single Family <br />$200 <br />Dwelling/Principal Building- Multi -Family $300 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />Commercial/Industrial Building $300 <br />Addition to Commercial/Industrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) $150 <br />Addition to Accessory Structure <br />$150 <br />Bunkhouse $250 <br />Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (Cl & I1) $200 <br />Addition to Accessory Structure -Commercial (Cl & I ) <br />$200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures $125 <br />Gazebo (WI Stat 59.692(l v)) <br />Filling/Grading <br />$350 <br />$150 <br />Camping Unit (Six Months Per Year) $100 <br />Boathouse <br />$500 <br />Permit Extension (Valid for one year - Only 1 Allowed) $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: p,�3 't, o /& s / , + ©t'Y <br />Property Owner's Mailing Address: <br />Property Site Address: 71 5-y S. <br />yS. Z <br />t.Thorn s�Ft <br />_ City State Zip <br />Contact's Telephone Number: 6'16 % — ,?l 6` y%/ "7 <br />Contact's Email:__ Do c< 5� .S ro �U C' o m <br />Legal Description of Property: 7— / C' -s- Yn # +' 4e4/ l V g y <br />Section #: -53 Town #: y 0 N Range #: /T / 6 W Town of:y` ez ff <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): 33L� S 7 <br />Proposed Use of Structure/Addi ion: *11ow <br />Anticipated Start Date: (omd ,bin; Commercial Business; Bedroom: Deck; etc.) J <br />Building Contractor: e. 4-c yoA 4CSewer Installer: &)t cr P <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IIS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />J� 7 <br />�C-a \IY1 a e-�c <br />n <br />S� <br />mar � <br />�. O �i W M• 'o 0 N W K <br />S o r <br />- 1e� YY1 o pve. <br />1 4', <br />Date of staff site visit: Initials of site visit staff: S" <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />�4� <br />S -9-I0 <br />Page I of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />CA <br />2 <br />Ir <br />`T <br />CD <br />H <br />i <br />Fee Rec: <br />v <br />