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LAND USE PERMIT APPLICATION -- Burnett County, WI <br />mit Fees: <br />wellin ci al Building - Single family <br />$300 <br />Addition to DwellingfPrincipal Buildin - Sin le Family <br />$200 <br />Dwelling/Principal Building - Multi-Famil <br />$300 <br />Addition to Dwelling/Principal Building - Multi -Family <br />$200 <br />COmmerciaVIndust ial Build' <br />$300 <br />Addition to CommercialAndustrial Building <br />$200 <br />Accessory Structure(Non-Bunkhouse) <br />Addition to Ace. Structure <br />$150 <br />Bunkhouse <br />$250 <br />Accessory Structure -Commercial Cl &11) <br />$200 <br />Addition to Accessory Structure -Commercial Cl & 11 <br />$200 <br />DecklStairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Screen orches -in campgrounds only) <br />$125 <br />Gazebo Stat 59.692 lv) <br />$350 <br />camp!nd Unit <br />1 $100 <br />Filling/Grading <br />S150 <br />Permit Extension(Valid for one year - Only 1 Allow <br />$100 <br />Boathouse <br />$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. <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Applicant's <br />Applicant's Mailing Address; <br />Applicant Complete All Sections Below This Line <br />el, i e <br />'I c <br />State zip <br />Applicant's Telephone Number: E;� � — /� 0 --,�_% 9U <br />Applicant's Email:�j WA0 Ca lor . j j & 1 r' Cf &,: ,L Cowl <br />If staff has a question about this application how do you prefer to be contacted? Check one below. <br />[]Letter [,Phone JgEmail <br />Legal Descri tion: <br />Lot #: f CSM Vol._I-_ 2.6 _S OR <br />Lot #: Block #: Subdivision Name: OR <br />Gov't Lot #:_ OR 1/4 1/4 <br />Section #: Town #:4N Range #: 15— W Town of s : S <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 <br />Tax ID # (1-5 digits): - 15- „- 19 4 6_3 <br />Property Site Address:_ 14 &>i_ L ,,f l; ,' �• , <br />TYPE OF PERMIT(S): Check appropriate box/boxes <br />❑ Single Family Dwelling ❑ Multi -Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br />❑ Single Family Addition ❑ Multi -Family Addition ❑ Dedc/Patio. 0 Commercial Addition <br />❑ Stairs A Acc. Structure (Non -bunkhouse) O Bunkhouse ❑ Commercial Acc. Structure <br />❑ Permit Extension ❑ Gazebo — WI Stat 59.692(iv) ❑ Camping Unit ❑ Commercial Acc. Addition <br />❑ Boathouse 0 Screen porch — campgrounds only 0 Retaining Wall ❑ Sidewalk/Driveway <br />Proposed Structure/AdditionUse: 4CcL h, ,,,_ S4vt Su <br />Home(Cabin; Commercial Business; Bedroom; Deck, etc.) <br />Building Contractor: Ot ,) t, 4i , Master Plumber: <br />Anticipated Start Date: l 1 <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2016 <br />0 <br />n <br />iT <br />C <br />NZ <br />_Z <br />