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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> 70 <br /> Permit Fees: <br /> a <br /> Dwellin rinci al Building-Single Family $300 Addition to Dwellin rinci al Building-Single Family $200 0 <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwellin rinci al Building-Multi-Farm] $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 f Accessory <br /> Structure-Commercial Cl &Il $200 Addition to AccessoryStructure-Commercial Cl &11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screen porches-in campgrounds only) $125 Gazebo WI Stat 59.692(1 v $350 m <br /> Camping Unit $100 Filling/Grading $150 S <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 Boathouse $500 <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. 9 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. r <br /> 0 <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: e-ICL(AA-6 (- F0 )[ <br /> Applicant's Mailing Address: f�y 3 O� z L I tJyh S ren- W t �� V 3 V <br /> t�99 City State zip 2.X <br /> Applicant's Telephone Number: <br /> . r r 0 <br /> Applicant's Email: [�N VA }-' YA I -U ey <br /> 0 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N w l <br /> ❑Letter &hone ❑Email 5 <br /> Legal Description: 2-b S 2-Z (o vc ht, N E 57 C- C f 2- Lf 2 16 •-O 3 300 a. <br /> m <br /> Lot#: CSM Vol. Pg. OR 3' <br /> CA 0Q, <br /> Lot#: Block#: Subdivision Name: OR — o <br /> a <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: _ IAC 4 S o d /�J <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* <br /> Parcel#(24 digits): F t <br /> � z <br /> Tax ID#(1-5 digits): '53 Q ( n o <br /> Property Site Address: <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes FeeRec: <br /> Ll Single Family Dwelling Ll Multi-Family Dwelling 13Filling/Grading El Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs 9 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 <br /> n � <br /> Proposed Structure/Addition Use: N <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 0NO <br /> Building Contractor: IC V-o0(-Y Master Plumber: 20 <br /> Anticipated Start Date: I o (/<. a; <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application-Rev 3/2016 �� <br />