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LAND USE PERMIT APPLICATION — Burnett County WI Go <br /> permit Fees: <br /> r <br /> Dwelling/Principal Building-Sin le Family $300 Addition to DwellingjPrincipal Building-Single Family $200 O <br /> DwellinglPrincipal Building-Multi-Family $300 Addition to Dwellin rinci al Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Ace.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial CI &11) $200 Addition to Accessory Structure-Commercial CI &I1 $200 <br /> Deck/Stairs(Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screen orches-in campgrounds only) $125 1 Gazebo WI Stat 59.692(lv)) $350 <br /> r <br /> Camping Unit $100 Filling/Grading $150 °» <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 Boathouse $500 m <br /> 2 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> v <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> 0 <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: aa4d nN4 0 fA Gaw <br /> 2 � <br /> Applicant's Mailing Address: <br /> City State Zip < a <br /> 2. Ch <br /> Applicant's Telephone Number: <br /> o <br /> w <br /> Applicant's Email: <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> w <br /> Vfetter ❑Phone ❑Email <br /> Legal Description: JE <br /> w <br /> Lot#: CSM Vol. Pg. OR N I <br /> Lot#: Block#: Subdivision Name: OR o <br /> E <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: 3 9N Range#:_7 W Town of. Ny i4,/$ <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* M <br /> Parcel#(24 digits):6�- ON- �`�S- 1'7- , S_-ZO Y- c 00- o 116 c a X <br /> VV <br /> lcl�� n z <br /> Tax ID#(1-5 digits): y �' <br /> Property Site Address: <br /> n <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 EllDeck/Patio ❑ Commercial Addition v ' lo je te �f <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 <br /> ❑ Retaining Wall ❑ Sidewalk/Driveway <br /> Proposed Structure/Addition Use: Z"k—e- � 5 J`v�(/ �Q e Z o <br /> (Home/Cabi , Commercial Business:BedroomlDeeck;etc,. O <br /> Building Contractor: J E�//F-- <br /> Master Plumber: �✓V/�'�,o Z � iN <br /> Anticipated Start Date: 17 O _o <br /> Page 1 of 4 Z Cn [l7f <br /> Burnett County, WI Land Use Application—Rev 3/2016 4 (� <br />