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LAND USE PERMIT APPLICATION — Burnett County, WI g <br />Applicant Con lete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building - Single Family $300 <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />Dwelling/Principal Building - Multi -Family $300 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />Commercial/Industrial Building $300 <br />Addition to Commercial/Industrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) $150 <br />Addition to Accessory Structure <br />$150 <br />Bunkhouse $250 <br />Structural Alteration to Accessory Structure <br />$150 <br />Accessory Structure -Commercial (Cl & Il) $200 <br />jAddition to Accessory Structure -Commercial (Cl & I1) <br />$200 <br />Deck/Star atio/Retaining Walt/Sidewalk/Driveway & <br />Campground Structures $125 <br />Gazebo (WI Stat 59.69200) <br />Filling/Grading <br />$350 <br />$150 <br />Camping Unit (Six Months Per Year) $100 <br />Boathouse <br />1 $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) $100 <br />*NOTE: After -the -fact (when no permit is obtainedprior 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 />*/tems not listed above will be treated as accessory structures, such as: pergolas. landscaping, etc. <br />Property Owner's <br />Property Owner's Mailing <br />City <br />Property Site <br />Contact's Telephone Number: _7117 :1?1 — Q &V- <br />Contact's <br />Zip <br />Legal Description of Property: <br />Section #: Town #: ZN Range #: _W Town of: TV f tDIF 14 <br />*Attach additional page if needed for lengthy description OR attach a copv of the deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): -2y <br />tjj <br />Proposed Use of Structure/A ition; <br />C, 1Z <br />Anticipated Start Date: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: -1{ Sewer Installer: VIA <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMEN I CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: Initials of site visit staff: f <br />PERMIT APPROVED BY ZONING OFFICIAL DATE: ? J / <br />C/ <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />