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LAND USE PERMIT APPLICATION—Burnett County.WI a r <br /> � b <br /> Applicant Complete All Sections Below This Line n J <br /> Permit Types and Fees:(Check appropriate box boxes) ' �1 <br /> a JI__1 <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 n <br /> D ielhng/Prmegral Building-Multi-Family $300 Addition to DmellingfPrinnpal Building-Multi-Family 5200 O <br /> CommerciaUIndustrial Building 5300 Addition to Commercial/Industrial Building 5200 <br /> Accessory Strueture(Non-Bunkhouse) $150 Bunkhouse 5250 <br /> Addition to Arc.Structure S150 Addition to Accessory Structure-Commercial(Cl&I1) 5200 Q 1 <br /> Accessory Structure-Commercial(Cl&Il) $200 Gazebo(WI Stat 59.692(lv)) $350 r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalt/Driveway& Filling/Grading $150 �w <br /> Campground Screen Porches 5125 Boathouse $500 —' <br /> Camping Unit(Six Mon"Yca) 5100 / f: ( 1 S.Lvl <br /> Permit Fxtension(Valid for one year-Only 1 Allowed) <br /> z <br /> 'NOTE:After-tha-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a d�erent applGcabon form,see corresponding application and fees. <br /> *Items not listed above will be treated as accessory struentres,such as:pergolas,landscaping,etc. <br /> n <br /> Property Owner's Name: <br /> c � � <br /> Property Owner's Mailing Address: X03 S rn r <br /> SInbIW: el Wt� Z(o a <br /> pp city State zip o <br /> Property Site Address: �S 33� ►aonner- k)U e QiL 't-o,w j 7ACt-5py <br /> Contact's Telephone Number: bS( Z�(� cj r?' N O <br /> Contact's Email: JP :�Sel 0.atnQtir Com w <br /> P 38 1 <br /> Legal Description of Property: LotZ CSrtny if .nr �1tr7 bT 3 <br /> ��N e� ��_ y <br /> Section#: Town#: #: W Town of: J 9Lf-Spn� <br /> 0 <br /> *Attach addhonal page ifneededfor lengthy description OR attach a copy of the deed OR attach tax system pnuperlypage <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: l <br /> Anticipated Start Date: (HomeCabin;Commercial Business Bedroom;Deck;etc.) �^ _ <br /> m <br /> Building Contractor: Sewer Installer: n z <br /> E � <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDPI'IONS ONLY <br /> THIS PERMIT I1S SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> IMOO <br /> �� cr * o'vJ c�" tJVI 'I Q,�,Jet- ,r� iJ IefFeeRec: <br /> 10 - IS - 1 <br /> c�. s A C-- Ws w <. r TY-,e,04,^f\CV,45 <br /> 't ansa-F,-II�-iN• -n�•jv-\e, i .s 1 or <br /> s.l s e 4�j Q-r c s 11 �__ 'ro v_��<_,?�- h<_ce <br /> Date of staff site visit: initials of site visit staff: N Z <br /> PERMIT APPROVED BY ZONING OFFICIAc� DATE: 7 —DL-- I I <br /> Z no <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application- Rev 1/2017 Z �� <br />