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LAND USE PERMIT APPLICATION — Burnett County «'1 <br /> < <br /> m" y^ ►+ <br /> Permit Fees: a <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellingfPrincipal Building-Single Family $200 CL <br /> C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 °—' <br /> m <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 1 'o <br /> Accessory Structure-Commercial C1 &11) $200 Addition to Accessory Structure-Commercial CI &11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& o <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(l v) $350 r <br /> Camping Unit $100 Filling/Grading $l90 ° _ <br /> Permit Extension Valid for one year-Only 1 Allowed) 1 $100 Boathouse $500 w <br /> 2 <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. <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 c <br /> n <br /> Applicant's Name: <br /> Applicant's Mailing Address: c)�RT 4v- �2 c� ( PA-, Al�J r��C <br /> City State Zip < <br /> o <br /> Applicant's Telep Number: l0(0-S <br /> 0 <br /> Applicant's Email: - <br /> i <br /> If staff has a question about this application ow do you prefer to be contacted? Check one below. N <br /> 00 QP <br /> �jLe_tte hone []Email <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR 3" 1 <br /> Lot#: Block#: Subdivision Name: OR c i <br /> Gov't Lot#: OR 1/4 1/4 7 �1 <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach addition/page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Parcel#(24 digits): <br /> � z i <br /> Tax ID#(1-5 digits): y �' <br /> r <br /> Property Site Address: IR <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> El Single Family Dwelling 13 Multi-Family Dwelling L3Filling/Grading ❑ Commercial Building <br /> ❑ 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(ly) ❑ Camping Unit ❑ Commercial Acc. Addition 00 <br /> Ll <br /> Boathouse 13Screen orch-campgrounds only L3Retaining Wall L3Sidewalk/Driveway <br /> Proposed Structure/Addition Use: <br /> ��� oM n <br /> (Home/Cabin;Commercial Business:Bedroom;Deck;etc.) Z <br /> W <br /> Building Contractor: Master Plumber: G) © v <br /> Anticipated Start Date: Z o <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 3/2016 <br />