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LAND USE PERMIT APPLICATION— Burnett County, WI c <br /> a <br /> Permit Fees: 0 c <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le 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 <br /> Accessory Structure-Commercial CI &II $200 Addition to Accessory Structure-Commercial Cl &Il $200 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& < <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692 lv) $350 r <br /> Camping Unit $100 Filling/Grading $150 R <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 Boathouse $500 d <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. ' y� <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. o J` <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. <br /> o — <br /> Applicant Complete All Sections Below This Line o <br /> h Applicant's Name: JA/77 C,.l7- <br /> x Applicant's Mailing Address: d.)ry JF / A N 6 v, �A/� 'f�B C b <br /> City State zip <br /> �)l Applicant's Telephone Number: <br /> 0 <br /> w <br /> Applicant's Email: <br /> i <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. kiN <br /> ❑Letter f hone []Email <br /> Legal Description: d <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR c 1 <br /> Gov't Lot#: OR 1/4 1/4 � <br /> 0 <br /> ra <br /> Section#: Town#: N Range#: W Town of: s ` I <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> 0 <br /> Parcel#(24 digits): x <br /> Tax ID#(1-5 digits): � ✓ <br /> Property Site Address:'-7t6 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes s <br /> E3Single Family Dwelling Ll Multi-Family Dwelling L3Filling/Grading ElCommercial Building Fee Rec: <br /> ❑ Single Family Addition ❑ Multi-Family Addition XDeck/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 /> L3 Boathouse <br /> Boathouse ElScreen porch—campgrounds only 13 Retaining Wall LlSidewalk/Driveway C ----��_��� <br /> Z oProposed Structure/Addition Use: dL� OR1 ?0-5 6-n So !+ % 5 s <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Z 1 <br /> QZ 1®! Y <br /> Building Contractor: Master Plumber: 2 O ry <br /> 0 <br /> A' <br /> Anticipated Start Date:I V� w� L � <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 3/2016 <br />