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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building- Single Family <br />$300 <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />Dwelling/Principal Building- Multi -Family <br />$300 <br />Structural Alteration to Dwell ingiPrincipat Buildings <br />$200 <br />Commercial/Industrial Building <br />$300 <br />lAddition to CommercialIndust rial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 <br />jAddition to Accessory Structure <br />$150 <br />Bunkhouse <br />$250 <br />:Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (Cl & Il) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & 11) <br />$200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />Gazebo (WI Stat 59.692(lv)) <br />$350 <br />$125 Filling/Grading <br />$150 <br />Camping Unit (Six Months Per Year) <br />$100 <br />Boathouse <br />$500 <br />Permit Extension (Valid for one year - Only I Allowed) <br />$100 <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. <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: <br />0 On< r-lr--5 C <br />Property Owner's Mailing Address: $ 16 1V � <br />Property Site Address: <br />© W, [ ewpi <br />State <br />X30 <br />Contact's Telephone Number: <br />Contact's Email: r 4 T ;5Lav dC e 1'l ra i�-yt e ! , )l e C. <br />Legal Description of Property: I&V9 Q,'Xs kDI 3 JrAT Zd 0 ky-k TS I ` Z <br />Section #: Town #: N Range #: W Town of: N_IM4) <br />*Attach additional page if neededfor 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): <br />Proposed Use of Structure/ di ion: 5,10 <br />Anticipated Start Date: /016'1 -1% 17 <br />Building Contractor: <br />�IAQP3S1,W S - W� <br />(Home/Cabin; Co)hmercial Business; Bedroom; Deck; etc.) <br />Sewer Installer: <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDI'T'IONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: T I ) Initials of site visit staff: -5cs <br />PERMIT APPROVED BY ZONING OFFICIAL: +^'�k�__DATE: <br />,C <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />C <br />Cr <br />a. <br />e' <br />o' <br />�, <br />-) I <br />b <br />n. <br />r <br />m <br />n <br />C" <br />b <br />H+ <br />b <br />z <br />it <br />Fee Rec:i5b <br />