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Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br />Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br />Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 1 jPermit Extension (1 Year Extension - Allowed Once) $100 <br />*NOTE: After -the -fact permits (permit aqui red after construction has begun) may cost 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: 0e eL /) 10-A CO <br />Property Owner's Mailing Address: '7160 dal-isAve- . ; I C &le+r' N 5 <br />rr'' City ztr State Zip <br />Property Site Address:,)7(o�- O (( 0.11 " 10a� Spooner., L J 7 `1 � � � ' <br />Contact's Telephone Number: G 1 � . 803. (�a7 <br />Contact's Email: beetker• TOVndo-+,iU►'1 2qwvx-1 caroti <br />Legal Description ofProperty: Loo `3(:sm vol -.274-113 . n Sov 10+ y, Stir a5-TIJOA/ <br />Section #: Town #: N Range #: W Town of: z IqiA1 <br />*Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br />Tax ID # (1-5 digit number; found on tax statement): r <br />Proposed Use of Structure/Addition: d6 i ire n S Gtr rt Fec r T co -61n <br />Anticipated Start Date: f 5 014 <br />; Commercial Business; Bedroom; Deck: etc.) <br />Building Contractor. C'PC(, CpnS 1frUC t'O✓tewer Installer: <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: Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIA 4� DATE: <br />UPON APPROVAL: APPLICA , MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 1/2018 <br />