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LAND USE PERMIT APPLICATION— Burnett County. WI70 <br /> a <br /> Permit Fees: 0 y <br /> � V <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 !,Z p <br /> Dwell in Princi al 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) FO <br /> Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial C 1 &11) $200 Addition to Accessory Structure-Commercial C 1 &I I) $200 <br /> Deck/Stairs/Pado/Retaining Wall/Sidewalk/Driveway& 0 1 <br /> Screenporches-in campgrounds only) $125 Gazebo WI Stat 59.692(1 v)) $350 C <br /> Camping Unit $100 Filling/Grading $150 ° <br /> Permit Extension Valid for one year-Only I 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. W I <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> 'v <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> s - <br /> Applicant Complete All Sections Below This Line o <br /> � ( 1 <br /> Applicant's Name: ion J DIt 4 <br /> Applicant's Mailing Address: ��6 �/`�Pll�s �- jive 941 <br /> City State zip <br /> Applicant's Telephone Number: <br /> d <br /> w <br /> Applicant's Email: <br /> G i <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter [?Phone ❑Email 7/S"� -��y% 'N'G <br /> oc <br /> Legal Description: o <br /> Lot#: CSM Vol. Pg. OR Q- G��, 2,�'2 v <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 ' l <br /> Section#: Town#: N Range#: W Town of: U� <br /> I <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Parcel#(24 digits): 07 <br /> '69/.7 "o2 -YO -IS -S -GS -ay/ •y 3;t p oo <br /> n Z <br /> Tax ID#(1-5 digits): e/�-fa1 I / 1 y �' <br /> Property Site Address: 3J 73 Pd,";h►�f V4 Rd Wdhic K <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: ( <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> /V 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(Sv) ❑ Camping Unit ❑ Commercial Acc. Addition <br /> ❑ Boathouse ❑ Screen porch-campgrounds only ❑,(Rettaaining Wall ❑ Sidewalk/Driveway � i r—,'l <br /> Proposed Structure/Addition Use: 6�� f4r J!l sIr" ^ Z C <br /> m <br /> (Hoe/Cabin:Co pmmQr�al Business:Bedroom:Deck:etc.) N m <br /> Building Contractor: J+ U4_6Master Plumber: h � r Z <br /> J Y •77 <br /> 2c) <br /> Anticipated Start Date: fi <br /> Page 1 of 4 Z <br /> Burnett County,WI Land Use Application—Rev 3/2016 <br />