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LAND USE PERMIT APPLICATION - Burnett County WI <br /> � C <br /> 0. b <br /> y ^ 1 <br /> F <br /> Permit Fees: o' <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 O <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 n <br /> Accessory Structure-Commercial Cl &I1 Addition to Accessory Structure-Commercial Cl &Il) $200 <br /> Deck/Stairs/Patio/Retaining WalUSidewalk/Driveway& <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(lv)) $350 r <br /> Camping Unit $100 Filling/Grading $lgp — ° <br /> Permit Extension Valid for one year-Only l Allowed) $100 Boathouse $500 v <br /> a <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. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: t C 14 AV,Q <br /> Applicant's ant's Mailing Address: � P f�04� kL TY K.37 b City State Zip X< <br /> O y <br /> Applicant's Telephone Number: C�y t(u0 0 c <br /> Applicant's Email: eA et h 6W `t I q3 <br /> b 1 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> ❑LetterPhone ❑Email <br /> w' <br /> Legal Description: 0 1 <br /> N <br /> Lot#: CSM Vol. Pg. OR �' I <br /> v, <br /> SU <br /> Lot#: �� Block#: Subdivision Name: OR o t <br /> Gov't Lot#: OR 1/4 1/4 1 ( 1 S I L ` �) <br /> �nl���S?tr tnqq P,Y1�5 <br /> Section#: Town#: N Range#: W Town of: V 1 <br /> *Attach additional a e if neededfor lengthy description OR attach a copy of the deed OR attach tax system property Page.* W 9 <br /> c <br /> Parcel#(24 digits): <br /> r, z <br /> Tax ID#(1-5 digits): -3331-7 `` 1 L x' NJ <br /> Property Site Address: (� ( ct W ft �1 1 T ti, . ��Ceje Yl c� (y y 5Y p 3�2 C C <br /> r <br /> TYPE OF PERMIT(S): Check appropriate box/boxes sFee Rec: �a <br /> ❑ Single Family Dwelling LJ Multi-Family Dwelling ❑ Filling/Grading LlCommercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs �K Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition a <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway W <br /> C <br /> Proposed Structure/Addition Use: E+:oro o�� o yid S e a�int�r Z <br /> (Home/Cabin;Commercial Business; dmom:Deck:etc.) O M <br /> Building Contractor: S c Master Plumber: Z ry <br /> Z t7 ~ o <br /> G) O c <br /> Anticipated Start Date: C <br /> Page 1 of 4 o, M <br /> Burnett County,WI Land Use Application —Rev 3/2016 <br />