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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> a <br /> Applicant Complete All Sections Below This Line a <br /> v <br /> Permit Types and Fees:(Check appropriate box/boxes) a <br /> d <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 <br /> Commercial/industrial Building $300 Addition to Commercial/Industrial Building $200 �, t <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 C) T (1 <br /> G� lJ J <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <_- <br /> Accessory Structure-Commercial(Cl&Il) $200 1 Addition to Accessory Structure-Commercial(Cl &11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 y <br /> w <br /> Campground Structures $125 Filling/Grading $150 <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 ` <br /> o <br /> Permit Extension(Valid for one year-Only I Allowed) $100 0 �, a <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 applicationform,see corresponding application andfees. <br /> o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a <br /> /�� w CJ <br /> Property Owner's Name: (J/-F a LA W r! t K y <br /> Property Owner's Mailing Address: W 1 . 0 �" ✓LI , n <br /> City State Zip d <br /> Property Site Address: 9 L 3$7 co Q cL. �7 g <br /> Contact's Telephone Number: 2/ S ' 3©7— q33 D_ o 1 <br /> av <br /> Contact's Email: ";n ra- harI l-m a.d . Co rix O <br /> N <br /> ti <br /> Legal Description of Property: 5 Q-�e- G .yL� / <br /> Section#: Town#: N Range#: W Town of:W 4 5y' /n.,,S�t" a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 3E <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: 5'ry r'A e <br /> Anticipated Start Date: <br /> p -7-oZ 0_3D 177 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � <br /> Building Contractor: 4t-1010-- Con,±, Sewer Installer. y z <br /> N r�1 <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISITED BELOW: Q <br /> \/A-y-) vk4�,t-3 <br /> \ill Fee Rec: 1��vtrlJ <br /> m <br /> O <br /> Zy� <br /> Date of staff site visit: � t� Initials of si a visit staff: � � DC� �� C <br /> z <br /> Nv <br /> PERMIT APPROVED BY ZONING OFFICIAL• i DATE: <br /> N <br /> O <br /> Page 1 of 3 V (J71 <br /> Burnett County,WI Land Use Application-Rev 03/2017 <br /> 3 <br /> 9 <br /> x <br /> m <br /> a <br /> m <br />