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LAND USE PERMIT APPLICATION - Burnett County, WI <br />Applicant Complete All Sections Below This Lilie, <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 />DwellingJPrincipal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />t� <br />a <br />Commercial/Industrial Building <br />$300 <br />Addition 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 & I1) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & 11) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(lv)) $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) 1 <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: & K <br />Property Owner's Mailing Address: <br />Property Site Address: <br />i,LMAA�& (_ I -e L-1 s i <br />7 T- *0 A �� <br />Contact's Telephone Number: -7 ) � � � �o — / ?-,f <br />City State Zip <br />`j ►° e e,-1 l,� ," < Y k 7 Z <br />Contact's Email: TA I I AA A i L� e s C A r nn Q (� M /3 1 f L; C G/? <br />Legal Description of Property: c e , T e t) <br />Section #: Town #: N Range #: W Town of: t f P-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): <br />Proposed Use of Structure/ ddition: <br />Anticipated Start Date: - Z C <br />(HomelCabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: InAr l G Sewer Installer:� C� � C jt/S GA✓ <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: I' _ I _ 1 In' 'als of site visit staff: �'`'' <br />PERMIT APPROVED BY ZONING OFFICIAL. DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />"If <br />ro <br />n <br />0 <br />b <br />as <br />d <br />vn, <br />r <br />b <br />• WN <br />Fee Rec: Q-00 <br />W <br />O <br />(T1 <br />N <br />z Q! <br />� C <br />00 M <br />O <br />t� <br />a <br />C: <br />o Z <br />v <br />b <br />