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LAND USE PERMIT APPLICATION-Burnett County, WI b <br /> y 1 <br /> N <br /> Applicant Complete All Sections Below This Line o e v <br /> Permit Types and Fees:(Check appropriate box/boxes) a f <br /> Dwelling/Principal Building-Single Family $300 11 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Structural Alteration to Dwelling/Principal Buildings $200 O <br /> Commercial/Industrial Building $300 1 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) 5150 I Addition to Accessory Structure $150 <br /> n <br /> 0 <br /> Bunkhouse $250 1 Structural Alteration to Accessory Structure $150 <, <br /> Accessory Structure-Commercial(CI&Ill $200I Addition to Accessory Structure-Commercial(CI &I I) $200 t <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 m <br /> Campground StructuresSI'_� Filling/Grading $150 e• <br /> Camping Unit(Six Months Per Year) $loo Boathouse $500 a <br /> m <br /> Permit Extension(Valid for one year-Only 1 Allowed) $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 diIerent application form,see corresponding application and�ees. <br /> Q <br /> *items not listed above will be treated as accessoty structures,such as.pergolas,landscaping,etc. v <br /> Property Owner's Name: A Vl Ae r S cn- <br /> y ik <br /> Property Owner's Mailing Address: © u 3 OL A U IG Smols <br /> C,ty State Zip o <br /> Property Site Address: (o'29 5- 41 C 0n r7Drs L k (n <br /> 1e� jp1 Ay- 5 3 <br /> Contact's Telephone Number: P/-'5 I—�20 9_Q tc O 7 o ao <br /> n w <br /> I <br /> Contact's Email: f? C(/-Y'�/ # /Yrid ,QrScrY� (eiJ/� A p77-e t <br /> 1' � x. <br /> Legal Description of Property: Y• f. <br /> Section#:35 Town#: N Range#: W Town of: <br /> H <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 1 0 <br /> Tax ID#(1-5 digit number;found on tax statement): H <br /> Proposed Use of Structure/Addition: cp l 5� r r �&5 e- <br /> Anticipated Start Date: 1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor:S)e is on &H Sewer Installer: d z I <br /> y <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Re4—cM1 <br /> ti <br /> y <br /> l7 <br /> rn <br /> N <br /> O <br /> Date of staff site visit: Initials of site visit staff- <br /> NZ n ^� <br /> PERMIT APPROVED BY ZONING OFFICIAL: DATE: <br /> O <br /> Page 1 of 3 $Jo C <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> b <br /> z <br /> a <br /> m <br />