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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> t;' <br /> y.d <br /> Permit Fees y 7 c o� <br /> a <br /> Dwellin rinci al Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 � O <br /> DwellinglPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> ems.. <br /> Commercial/industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Ace.Structure $150 Bunkhouse $250 t <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accesso Structure-Commercial Cl &Il $200 <br /> 0 <br /> DecWStairs/Patio/Retaining Wall/Sidewalk/Driveway& � <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(l v) $350 PrZZ <br /> Camping Unit $100 Filling/Grading $150 ° <br /> Permit Extension Valid for one year-Only 1 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. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a , <br /> s - <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: <br /> Applicant's Mailing Address: 4 <br /> City State zip C ,t <br /> O y <br /> Applicant's Telephone Number: 6.5 (- 77C ^ TZ 6 8 E <br /> v <br /> Applicant's Email: Au is hg i r _ JS it oo r Go n1 <br /> ro <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> ❑Letter Phone MEmail <br /> Legal Description: rc ,-"-VtL6&—A b <br /> y <br /> Lot#: CSM Vol. Pg. OR 0' <br /> v, <br /> Lot#: Block#: Subdivision Name: OR o <br /> f <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. <br /> Parcel#(24 digits): <br /> 1J ` n z <br /> Tax ID#(1-5 digits): 1 1-l �Qv� \ ! J y <br /> Property Site Address: O W I r m a\,,. <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 /> ❑ 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 <br /> ❑ Boathouse ❑ Screen porch-campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway <br /> C <br /> Proposed Structure/Addition Use: C m � <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: &r e- 5, Master Plumber: Cr, <br /> N <br /> Anticipated Start Date: lYl tl.c� lS'F' rn <br /> Page 1 of 4 �1 <br /> Burnett County,WI Land Use Application —Rev 3/2016 <br />