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LAND USE PERMIT APPLICATION — Burnett County, WI a <br />a' <br />Applicant Complete All Sections Below This Line 7 <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 />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 & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (Cl & Il) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Lebo (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) <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 <br />Property Owner's Mailing Address:_ <br />Property Site Address: 'L 88 - - <br />D Cir— R <br />1 54-1,D ( <br />City State Zip <br />Contact's Telephone Number: -I 157— S -(o 6 — to g bask Ax- , <br />LoT 1 Csnn v �1 � S7 <br />Contact's Email: :Jn s i,t peck- $3 �j %IvAe. 7 t <br />1 i S• <br />Legal Description of Property 0 "Z ® 7-8 --Z -- 4V 0 (4 " 1 b ' S ' O `5 - 003 - O O <br />Section #:(b Town #:_�ZN Range #:--L-4—W Town of: S C6 -4" 4_ <br />*Attach additionalpage 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): ( 81 +,; <br />Proposed Use of Structure/Addition: D-e.C� " S � .691 � IV) 6 <br />Anticipated Start Date:„ 1�rsL. t,ptjr (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: Pe c, �_ 16-C Sewer Installer: <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />APPROVED <br />Date of staff site visit: ^ " / Ini ials of site visit staff: S� <br />PERMIT APPROVED BY ZONING OFFICIAL: / DATE: <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />III <br />°o <br />b <br />r <br />b <br />0 <br />0 <br />U) <br />'v <br />z <br />Fee Rec: Xc' oo <br />s <br />v <br />m <br />N <br />O <br />z <br />a <br />� <br />Ppry <br />o <br />-Ij <br />x <br />m <br />a <br />m <br />