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LAND USE PERMIT APPLICATION - Burnett Countv, WI <br />Annlicant Comnlete All Sections Below This Tine <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 />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />Accessory 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 & II) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & II) $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 />$100 <br />Boathouse $500 <br />Permit Extension (Valid for one year - Only I Allowed) <br />$100 11 <br />1 <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: m 1 K 5 3 a AgC?L <br />Property Owner's Mailing Address: -901140 2 R I <br />Property Site Address: 30-7 a 5 T ©W <br />acR m on <br />j Son R0 DANBURy W1 <br />WRE <br />Contact's Telephone Number: -I I S - 9&6, - '1 15 <br />Contact's Email: S P I KC in A9 St14QW IQ 67, A) E -T <br />State Zip <br />Legal Description of Property: N 72 N W 'N S& - CT' w a s q towns tl l P L41A) t &WL:67- <br />Section #: Town #:1" �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 property page. <br />Tax ID # (1-5 digit number; found on tax statement): a 6 11 t <br />Proposed Use of Structure/Addition: #4 Q ►4 & L= - WORK S H O P 3 O x g 6 <br />Anticipated Start Date: & — I I a 0/ S (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: MIKL; (oRmAtn Con SP. Sewer Installer: ROSS f'dL f)Oale <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />\J -,P-- <br />_ _�� <br />Date of staff site visit: 5 � � Initials of site visit st ff: <br />S- IS <br />PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br />of <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />°o <br />0 <br />w <br />5 <br />-Z <br />z <br />X00 <br />:' / �- <br />Fee Rec <br />T a),(, a713 <br />