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v7 I t >•. <br /> LAND USE PERMIT APPLICATION —Burnett County, W1 a _ ^' <br /> Applicant Complete All Sections Below This Line <br /> Permit T}uas and Fees:(Check appropriate boxlboxes) o <br /> c <br /> w <br /> UwdL•cgiPrincipai Building-Single Family $300 Addition to D�wlling/Principal Building-Single Family $2D0 :o i <br /> DNwIlincTrincmal Building-Multi-Family $300 Addition to DH llme/Pnncipal Building-Multi-Family $200 C <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 ( r m <br /> Accessory Structure(Non-Bunkhouse) $150 Bunkhouse $250 C' <br /> Addition to Acc-Structure $150 Addition to Accessory Structure-Commercial(CI &I I) S20l <br /> of <br /> Accessory Structure-Commercial(CI &Il) $200 Gazebo(WI Stat 59.692(lv)) 5350 b <br /> ' I <br /> :o <br /> DeckS1 <br /> ' ain'Patio/Re[aning Wall/Sidewalk/DrivFilling/Grading 5150 <br /> eway& tl <br /> lCarntivround Screen Porches $125 Boathouse S$00 <br /> I Camping Unit(Six Months/Year) $100 <br /> Permit Extension(Valid for one year-Only I Allowed) $100 ?_ <br /> b_ <br /> _ z <br /> *vCSTE;A fter-the-fact(when no permit is obtained prior to construction)is up to three times[he normal fee. <br /> *Communication Tot+'ers&Signs require a different application form,see corresponding application and fees. o <br /> *Items riot luted above will be treated as access ory structures,such as:pergolas,landscaping,etc. a <br /> Property 0L ner's Name: f;f1QET ✓t^� TnJ3T I�•4tE✓f4 t/ST $ Z[+ G�' 3 < <br /> M t� .o�� < r✓r 4-y Gr — re4/s. F s o � <br /> Property Owner's Mailing Address:/Q, c /V Tc rt [oJ fJG v, <br /> yes Of <br /> City I State Zip <br /> Properly Site Address: 24,61 W{441E PWFalll 1L RCUC-'L�te 41 5*gR3-7 <br /> Contact's Telephone Number: 4S� — �.70 (o l3 2- <br /> Contact's <br /> Contact's):mail: <br /> Legal Description of Property: Lb-r /S T 4-r il W144fp"l44� A,4ef dF_f 11Q17V►/rt' <br /> N ` <br /> Section#:_ 1Z ._Town 4:37 Alll _N Range 4:_j W To„nofi)E 1, <br /> , g <br /> *.attach additrbtal page if needed for lengthy description OR attach a copy of the deed OR attach tax s.vstem property page. <br /> Tax ID#(1-5 digit number: found on tax statement): 3 3 3 1!�_ <br /> Proposed Use of Structure/Addition: <br /> �� t�e.4d/•� - <br /> Anticipated Start Date:- �/ �{p 171 (Nome/Cabin, Commercial Business;Bedroom, Deck;etc.) <br /> d <br /> 7 Cr JS T�c1cTi /1 <br /> Buiiding Contractor: D/VE Cur �.. P.� Sewer Installer:CARLk rv) ✓fit��f 4 z <br /> E + at t/rel ti <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: OU VI v <br /> Y lV C.w o- .S V S e- S't �7 il cj Y-) y Fee Rec:_300.,a) <br /> o <br /> 5t <br /> z <br /> i <br /> 5 <br /> C a C <br /> Dateof staff site visit: L � � � Initials of site visit staff: <br /> fl 17 <br /> C <br /> PERM 1TAPPROVED BY ZONING OFFICIAL DATE: � o O <br /> *r z <br /> OD <br /> Pagel of3 I O o <br /> Burnett County, WI Land Use Application —Rev 02/2017 <br /> rr fiw <br /> F <br />