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LAND USE PERMIT APPLICATION — Burnett County, W1 a <br /> Applicant Co fete All Sectioa&B love This Line c <br /> Permit Types and Fees:(Check appropriate box/boxes) <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 <br /> Accessory Structure(Non-Bunkhouse) $150 Addition to Accessory Structure $150 <br /> Bunkhouse $250 Structural Alteration to Accessory Structure $150 <br /> Accessory Structure-Commercial(Cl&11) $200 Addition to Accessory Structure-Commercial(Cl &I1) $200 t <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& Gazebo(WI Stat 59.692(lv)) $350 En <br /> Campground Structures $125 Filling/Grading $150 <br /> m <br /> Camping Unit(Six Months Per Year) $100 Boathouse $500 <br /> �a <br /> Permit Extension(Valid for one year-Only 1 Allowed) $100 r. <br /> 0 <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. o <br /> *Items not listed above will be treated as accessory structures,such as:pergo�lajs, lan'ds/c�aping,etc. ,, �7 <br /> R. <br /> s Property Owner's Name: t R� �l • „+\ C `=' _L— Ctz QT_ ro <br /> rnC N <br /> Property Owner's Mailing Address: Z + f L 4 �-- (�� ( a a ~ <br /> jF City State Zip C7 <br /> Property Site Address: �►�`� ' <br /> Contact's Telephone Number: 5U-7 -ZS''( � 37 0 1 � <br /> Contact's Email: a`-�3 V e-C a -V'U'6 T f \/e V—�u �p . C C) PA <br /> t7 <br /> Legal Description of Property: _ ~��� �- <br /> Section#: Town#: N Range#: W Town of: `� H <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): Z g <br /> Proposed Use of Structure/Addition: 11—is 6; L0r\/ + <br /> Anticipated Start Date: _MG� 2!L9( (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Mt <br /> Building Contractor: �- Sewer Installer: cpV_oA S N z <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Fee Rec001D <br /> m <br /> Date of staff site visit: Initi Is of site visit staff: <br /> M <br /> PERMIT APPROVED BY ZONING OFFICIAL• DATE: �� l7 o <br /> C/ 0 <br /> Page 1 of 3 <br /> Burnett County,WI Land Use Application—Rev 03/2017 <br /> ro <br /> x <br /> m <br />