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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 $300Addition/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(iv) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) 1$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: rho. 0 <br />Property Owner's Mailing Address: --,d3 3 * <br />CityState Zip <br />Property Site Address:�J `� s / citS t 7— <br />Contact's Telephone Number: I Z - 7 b `7 — &,02 - <br />Contact's <br />,OZContact's Email: RV C H P P L G MA l L. lE(' <br />Legal Description of Property: PC -L Coy, Let I— <br />Section #: Town #: -3 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): <br />i` <br />Proposed Use of Structure/Addition: d A. + i Ft, t j q 4r 16 N �k <br />Anticipated Start Date: --ry N ,� t 2® I Z (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: ow � � 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 />Date of staff site visit: _ I — f I .als of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL DATE: <br />UPON APPROVAL: APPLICANT UST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page I of 4 <br />Burnett County, WI Land Use Application — Rev 1/2018 <br />a <br />r <br /><� <br />b <br />a <br />b <br />o <br />�C1 <br />o <br />ro <br />rc <br />z <br />� <br />o <br />o <br />P <br />a <br />� <br />n <br />V <br />c <br />i9 <br />�-- <br />d <br />� <br />5 <br />rA <br />W <br />5 <br />m <br />a <br />A <br />[n <br />v <br />"v <br />Ln <br />C'o o <br />C <br />z I� <br />� 5 <br />�e <br />d <br />.o <br />Fee Rec: <br />zo <br />c,4 --i# /O 96,5-1,7 <br />Ez <br />N <br />O <br />co <br />