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LAND USE PERMIT APPLICATION— Burnett County, WI a b <br /> Permit Fees: a � <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 d <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaUindustrial Buildin $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I 7 <br /> Accessory Structure-Commercial C I &Il 52 0 Addition to Accessory Structure-Commercial Cl&I l) $200 <br /> Deck/Stairs/Patios $125' Gazebo WI Stat 59.692(lv)) $350 <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed) I $100 S <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. a, <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. I <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping, retaining walls. 4i E <br /> Applicant Complete All Sections Below This Line o �. <br /> �- Z <br /> Applicant's Name:___l <br /> Applicant's Mailing Address: <br /> City State ZipLI <br /> mn <br /> Applicant's Telephone Number: (q�, J (' C) o '� <br /> Applicant's Email: — MO <br /> ( �( <br /> 1 � <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. 1 <br /> ❑Letter ❑Phone mail N <br /> 0 <br /> Legal Description: W' <br /> Lot#: CSM Vol. Pg. OR <br /> m <br /> Lot#: Block#: Subdivision Name: OR a, <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.* v <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): z <br /> Property Site Address#: 6 I \ ' t 1 <br /> Road Name: EllWs Or- City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: Iib <br /> ❑ Single Family Dwelling <br /> El Dwelling ❑ Filling/Grading Ll Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition 14 <br /> tains ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure °m 00 <br /> Permit Extension 13Gazebo–WI Stat 59.692(ly) 13Camping Unit LlCommercial Acc. Addition z M <br /> Z c <br /> Proposed Structure/Addition Use: > N m r ^ <br /> (Home/Cabin;Commercial Business:Bedroom:Deck:etc.) r Z u u <br /> Building Contractor: a)0 o <br /> Anticipated Start Date: m Z <br /> Page 1 of 4 c �J <br /> Burnett County, WI Land Use Application—Rev 4/2015 <br /> m <br /> A <br /> m <br />