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LAND USE PERMIT APPLICATION— Burnett County, WI r <br /> N rt <br /> N <br /> Permit Fees: o' <br /> a � <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 i O <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwellin rinci al Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaUIndustrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) E <br /> Addition to Acc.Structure $150 Bunkhouse $250 y <br /> Accessory Structure-Commercial C1 &Il $200 1 Addition to Accessory Structure-Commercial CI &I1 I $200 <br /> Deck/Stairs/Patio/Retaining WalUSidewalk/Driveway& o <br /> Screenporches-in campgrounds only) $125 Gazebo WI Stat 59.692(l v) $350 <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only I Allowed $100 Boathouse $500 w <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 /> v <br /> */terns 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: A"c `a �(.(�ry'�� G <br /> Applicant's Mailing Address: A V i q a (Q L L <br /> City State zip <br /> q # <br /> PP P � / o a <br /> Applicant's Telephone Number: 5 ss� ^Z �� ,�-1 <br /> �\ d <br /> Applicant's Email: +�� CJJ' t 1f t° Lr�l <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N t <br /> s� ❑Letter ❑Phone At <br /> Email <br /> Legal Description: d 3 S n\A 35 R I <br /> Lot#: `� 6 . SM Vo1.��Pg. OR <br /> t <br /> Lot#: Block#: Subdivision Name: OR o t <br /> F <br /> Gov't Lot#: OR 1/4 1/4 ° <br /> Section#: Town#: N Range#: 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 /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> Property Site Address: <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:� � <br /> El Single Family Dwelling El Multi-Family Dwelling L3Filling/Grading Ll Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway Im <br /> Proposed Structure/Addition Use: CS C <br /> � on <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r'rt <br /> Building Contractor: Master Plumber: nAnticipated Start Date: okC <br /> 0 ciig <br /> Page jof4 � <br /> Burnett County,WI Land Use Application—Rev 3/2016 �--� <br />