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LAND USE PERMIT APPLICATION — Burnett County, WI a _ <br /> Applicant Complete All Sections Below This Line ; r v <br /> Permit Types and Fees:(Check appropriate box/hoses) p ° <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 �'(\ <br /> D,Aelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 G� <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <, <br /> Accessory Structure-Commercial(Cl S I) $200 Addition to Accessory Structure-Commercial(Cl &11) $200 c 0 <br /> Deck/Stairs/Patio/Retaining Wall/SidewaWDriveway& Gazebo(WI Stat 59.692(lv)) $350 <br /> X Campground Structures $125 Filling/Grading $150 � <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> a <br /> Permit Extension(Valid for one year-Only I Allowed) $100 <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 different application form,see corresponding application and fees. c <br /> 0 <br /> */terns not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. a <br /> w_ n <br /> a ,9 <br /> Property Owner's Name: 0"O-D be DIANNE MGCt4,,r4N 3 z <br /> 14v, c y C> <br /> Property Owner's Mailing Address: 10'A i Kt ft1R Lie, N 4C N tt SL n t <br /> City State Zip o <br /> Property Site Address: [1Kj) WEST WhT PA SPC6rrpt2 144 54801 <br /> ) <br /> Contact's Telephone Number: 061-R55 -20e 7_ <br /> 7 <br /> Contact's Email: WEST Voi i`1T COM o <br /> ti <br /> Legal Description of Property: Gov-r ttrr I x 7- <br /> Section#: V) Town#: q0_N Range#: {fit W Town of: j COTT' C <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR'attachtax system property page.* 7'Z1 <br /> Tax ID#(1-5 digit number;found on tax statement): 47—33q !6Z 4 —I <br /> Proposed Use of Structure/Addition: psr*- FoK CAA.t Pc jw l —46 1 , <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Anticipated Start Date: 41Z#7 <br /> Building Contractor: Sewer Installer: y z 1 <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 <br /> Fee Rec:)Q_T OD <br /> x <br /> _N <br /> t7 <br /> m <br /> C <br /> Date of staff site visit: Initials of site visit staff: r <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: / o <br /> ti <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> m <br /> m <br />