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LAND USE PERMIT APPLICATION —Burnett County. WI _ <br /> y ~ <br /> Permit Fees: ; a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwellin inti al Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaVIndustrial Building $200 r. <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial C1&11) $200 Addition to Accessory Structure-Commercial Cl &I l) $200 <br /> Deck/Stairs/Patio/Retaining Wall/SidewaWDriveway& <br /> (Screenporches-in campgrounds only) 5125 Gazebo(WI Stat 59.692(lv)) 0 <br /> Camping Unit $100 Fillip Gradin $150 <br /> Permit Extension(Valid for one year-Only 1 Allowed $100 Boathouse $500 w <br /> 0 <br /> *NOTE:Ager-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. d <br /> *items not listed above will be treated as accessopy structures,such as:pergolas, landscaping,etc. <br /> 0 <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: �1 <br /> Applicant's Mailing Address: b <br /> City State Zip c 2 <br /> Applicant's Telephone Number: rl 3 O 8 `S`15-0 e 2 <br /> Applicant's Email: %C 4�N19P� t 2�We,- ('-0.44 <br /> b <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter ❑Phone RWhail <br /> Legal Description: C <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR 0 <br /> Gov't Lot#: OR 1/4 1/4 �d <br /> Section#: Town#: N Range#: W Town of: I `� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* > <br /> r <br /> Parcel#(24 digits): <br /> � <br /> n 1 1 � z <br /> Tax ID#(1-5 digits): /g •(V�,'1"��P e— p 1 o y <br /> Property Site Address: 6� � 1\O O..lam- <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: 61 ,t� <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 Ll Screen porch—campgrounds only ❑ Retaining Wall X Sidewalk/Driveway C <br /> IffiProposed Structure/Addition Use: z m <br /> (Nome/Cabin;Com tialBusiness;Bedroom;Deck;etc.) 1Tl <br /> Building Contractor: Master Plumber: <br /> Anticipated Start Date: D O o <br /> T <br /> Page 1 of 4 Z <br /> Burnett County, WI Land Use Application—Rev 3/2016 CLJ <br /> � <br />