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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 $200 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />Commercial/Industrial Building <br />$300 <br />Voopo <br />;co <br />lAddition to Commercial/Industrial Building $200 <br />Accessory Structure(Non-Bunkhouse) <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (Cl & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & I1) $200 <br />Deck /St a irs/P atio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(]v)) $350 <br />Filling/Grading $150 <br />Camping Unit (Six Months Per Year) <br />$100 <br />Boathouse $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />$100 1 <br />1 <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: per olas, landsca in , etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: <br />Property Site Address: <br />Contact's Telephone Number: &S/ 23 1 -- 0'// <br />-✓(, so sf- 19C,4.l MN ,S YP )f <br />State Zip <br />Contact's Email: ,, y'n t' l /'e dk q l®_ qjIn fit` l , Co 1,2-1 <br />Legal Description of Property:A_�W x Oe -L V gy P•3Ro V a`3 f l i4 �X CSVn <br />Section #: V kX -A J8' 76SI ACX -0`3 ff ?bs3 <br />*Attach additional pag_ <br />Tax ID # (1-5 digit number; found on tax statement): a d, 9 a) <br />d <br />Proposed Use of Structure/Addition: -No tjF— <br />Anticipated Start Date: (HomeiCabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: <br />Sewer Installer: <br />rty page• * <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />- � <br />Date of staff site visit43--- 1 j Sig. Init a of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL- ' DATE:oko <br />C/ <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />0 <br />0 <br />n <br />0 <br />H <br />Fee Rec:LIZ-1� <br />`o <br />zM <br />gG__2j� <br />Voopo <br />;co <br />IV <br />O <br />b <br />m <br />m <br />