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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building - Single Family <br />$300 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Commercial/Industrial Building <br />$300 <br />ZZ"cessory Struct ure(Non-Bunkho use) <br />$150 <br />Bunkhouse <br />$250 <br />Accessory Structure -Commercial (C1 & 11) <br />$200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures $125 <br />Camping Unit (Six Months Per Year) $100 <br />Permit Extension (Valid for one year - Only I Allowed) $100 <br />Sections Below This Line <br />Addition to Dwelling/Principal Building - Single Family <br />$200 <br />Structural Alteration to Dwelling/Principal Buildings <br />$200 <br />Addition to Commercial/Industrial Building <br />$200• <br />Addition to Accessory Structure <br />$150 <br />Structural Alteration to Accessory Structure <br />$150 <br />Addition to Accessory Structure -Commercial (CI & I1) <br />$200 <br />Gazebo (WI Stat 59.692(lv)) <br />$350 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <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 />Property Owner's Mailing Address: <br />Property Site Address: <br />City State Zip <br />—7-4x1_1 U—i1 _C lC-,GcC—/\21(,;nn <br />Contact's Telephone Number: i Z _ Z ton 46 <br />Contact's Email: <br />Legal Description of Property: Z <br />Section #: 3 Town #:Ll�) N Range #:__L_q W Town of- <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/Addition: <br />Anticipated Start Date;�A&_jW_- <br />Building Contractor: <br />Business; Bedroom; Deck; etc.) <br />Sewer Installer: <br />BELOWAREA ZO. FCOMMENTS/CONDMOM ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: p Initials 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 />0 <br />as <br />fnZ C) <br />0 <br />u: <br />r <br />o <br />Z <br />LA <br />a <br />b <br />x <br />m <br />z <br />