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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> y K 1 <br /> Permit Fees: o, <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 <br /> DwelfinglPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaVlndustrial Building $200 v O <br /> Accessory Structure(Non-Bunkhouse) f <br /> Addition to Ace.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial CI &11) $200 1 Addition to Accessory Structure-Commercial CI &I1) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(lv)) $350 r <br /> Camping Unit $100 Filling/Grading Filling/Grading $150 ° <br /> Permit Extension Valid for one year-Only 1 Allowed $100 Boathouse $500 m J <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 /> ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping, etc. — <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: O rv4oesc7. /c1� ^el <br /> Applicant's Mailing Address: ��� 1i tte n( 1 ( Cop. D4,Kbut-4 W,:P- <br /> City I State zip N <br /> y <br /> Applicant's Telephone Number: r/SoZ — 4 r,/E/4/ c <br /> d <br /> Applicant's Email: cin,c,; 1 r2i&A <br /> ro 1 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter Phone ❑Email <br /> w <br /> Legal Description: e <br /> N <br /> Lot#: CSM Vol. Pg. OR <br /> y <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 r I <br /> Section#: Town#: N Range#: W Town of. Q� y <br /> ( 1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Parcel#(24 digits): <br /> � z 1 <br /> Tax ID#(1-5 digits): y <br /> Property Site Address: PLAr r Kvko(( Rnl � it 910 <br /> i <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:� <br /> ❑ Single Family Dwelling El Multi-Family Dwelling LlFilling/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 /> M <br /> Proposed Structure/Addition Use: C c,a`V e t^fCat b i o ���c: Z C <br /> (Home/Cabin;Commercial B sines; room;De ;etc.) Ill z <br /> Building Contractor: Per Master Plumber: n t <br /> Anticipated Start Date: <br /> C <br /> Page 1 of 4 Z ll <br /> Burnett County, WI Land Use Application—Rev 3/2016 4 U <br />