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too <br /> LAND USE PERMIT APPLICATION— Burnett County, WI Cr b <br /> y 1 <br /> Applicant Complete All Sections Below This Line 7 i <br /> Permit Types and Fees:(Check appropriate boxlboxes) ° "t <br /> tz <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling(Principal Building-Single Family $200 (m"p <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 1 <br /> Addition to Ace.Structure $150 lAddition to Accessory Structure-Commercial(Cl &I l) $200 <br /> Accessory Structure-Commercial(CI &11) $200 Gazebo(WI Stat 59.692(lv)) $350 °r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Filling/Grading S150 ev, <br /> Campground Screen Porches $125 Boathouse $500 <br /> Camping Unit(Six Months(Year) $100 <br /> m <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 r <br /> 0 <br /> z <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. p <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> *hems not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> n <br /> Property Owner's Name: K b <br /> oor 0.Pro a Owner's Mailing Address: lwi c. / , <br /> h <br /> City State Zip d 7_�) <br /> Property Site Address: <br /> Contact's Telephone Number: x'07 JtJ �/ — 7�eU PJ b <br /> N � I <br /> Contact's Email: d/i�G (_00Lj G @ G iLjgri zc <br /> Legal Description of Property: C7 j� 65 rn w- 5 S'y k1�e g• <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): y <br /> Proposed Use of Structure/Addition: 4¢s _ <br /> Anticipated Start Date: A41 l44 f (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: n z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> I <br /> Fee Rec4 <br /> C <br /> Z <br /> Z m <br /> Date of staff site visit: initials of site visit staff: M ()D <br /> PERMIT APPROVED BY ZONING OFFICIA DATE: C7 n 0 <br /> Page 1 of 3 Z V <br /> Burnett County, WI Land Use Application—Rev 1/2017 <br />