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LAND USE PERMIT APPLICATION-Burnett County. WI b <br /> Applicant Complete All Sections Below This Line 'L <br /> v <br /> Permit Types and Fees:(Check appropriate box/boxes) <br /> Dwelling/Principal Building-Single Family $300 1 Addition to Dwelling/Principal Building-Single Family200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dxelling/Principal Buildings 00 V IC <br /> Co mmerciaVindustrial Building $300 Addition to CommerciaUlndustrial Building 5200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure 5150 <br /> Accessory Structure-Commercial(Cl&11) $200 1 Addition to Accessory Structure-Commercial(C1 &Il) 5200 <br /> Deck/Stairs/Patio/Retaining WalUSidevmlk/Driveway& Lebo(WI Stat 59.692(1 v)) $350 <br /> Campground Structures 5125 Filling/Cradmg $150 <br /> Camping Unit(Six Months Per Year) S100 lBoathouse 5500 <br /> m <br /> Permit Extension(Valid for one year-Only I AIIoHed) $100 S <br /> z <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 diSerent applicationform,see corresponding application andfees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolm,landscaping etc. <br /> n A <br /> Property Owner's Name:_Q <br /> I-�AV I "24r(K G K 0(wm <br /> Property Owner's Mailing Address: ev ,e G o(degL(JA(I " o <br /> City 9State Zip o <br /> Property Site Address: 30-51W TAlopt- <br /> Contact's Telephone Number:II W 3— ,�I- !!w ( N b <br /> Contact's Email: flute Ky CS [a_ �OwtCacs� nle— "' <br /> 1 <br /> Legal Description of Property: ov.. ' rwet . <br /> Section#: 1 Town#: L/I N Range#: /S W Town of. S..e i SS rr <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 1 <br /> o <br /> I <br /> Tax ID#(1-5 digit number;found on tax statement): a I U 41 -1 <br /> Proposed Use of Structure/Addition: Qo efl.b l O dr—L <br /> Anticipated Start Date: 12 r(T (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> A U, <br /> Building Contractor: 71cle- Sewer Installer: Em-c hnn� #Ic — $ z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee RecQQQ CC <br /> y <br /> atpv <br /> ICI— Z <br /> Date of staff site visit: Initials o ite visit staff: ' crr <br /> ? I N <br /> PERMIT APPROVED BY ZONING OFFICIAL* XX -) JDATE: C o t^1 <br /> Page 1 of 3 0 <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br />