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LAND USE PERMIT APPLICATION— Burnett County, N'C'I a r <br /> N » <br /> Permit Fees: 0' <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 Budding $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse1 <br /> $250 <br /> Accessory Structure-Commercial CI&II $200 Addition to Accessory Structure-Commercial(Cl&I1) $200 1f� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& ` <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(1 v $350 4 CL- <br /> Permit <br /> Cam in Unit $100 Fillin Gradin $150 <br /> Extension Valid for one year-Onl 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, ti <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. U <br /> Applicant Complete All Sections Below This Line o <br /> kviF <br /> / r / <br /> Applicant's Na me: -7/ C�/�t�� �z`?rW <br /> Applicant's Mailing Address: V /b S� E I C,-e(` 'W �O f(rlc6n2 , r <br /> Cit Stat6 Zip Z <br /> Applicant's Telephone Number: `I S ^��cis--OL 7 Z o a t <br /> Applicant's Email: J�C1P Lek 11?NS �'✓IQ 1 e �� <br /> I <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> 0 <br /> ❑Letter MPhon []Email <br /> � 4* Q <br /> sy <br /> Legal Description: t� d <br /> in <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR c <br /> Gov't Lot#: OR 1/4 1/4 F <br /> Section#: 4� Town#: d N Range#: W Town of <br /> *Attach additional page if needed for lengthy description <br /> ,OR�attach a copy of the deed OR attach tax system property page.* d <br /> Parcel#(24 digits): 07—off— Z <br /> S77 n z d <br /> Tax ID#(1-5 digits): I� y � <br /> w <br /> Property Site Address: <br /> b <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: (� <br /> L3Single Family Dwelling 13 Multi-Family Dwelling ElFilling/Grading LlCommercial Building I_1ZV <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs %Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure C <br /> E3 Permit Extension El Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition <br /> ❑ Boathouse ❑ Screen porch-campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway Z r,�-,-, <br /> r I m -0 (9—D <br /> Proposed Structure/Addition Use: --x JV1 Q -1 t D I <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) n c� <br /> N <br /> Building Contractor: C���(�rn n.S/}- Master Plumber: Z <br /> Anticipated Start Date: <br /> Page 1 of 4 �J <br /> Burnett County,WI Land Use Application-Rev 3/2016 <br />