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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> y " <br /> Permit Fees: <br /> DwellingfPrincipal Building-Single Family <br /> $300 Addition to Dwelling/Principal Building-Single Family $200 C7 <br /> DwellinglPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) �! t <br /> Addition to Acc.Structure $150 Bunkhouse $250 y <br /> Accessory Structure-Commercial CI &II $200 Addition to A cessory Structure-Commercial Cl &11) $200jj <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& o j <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(l v $350 <br /> Camping Unit $100 Filling/Grading $150 <br /> 0 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 Boathouse $500 w <br /> a <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. ti <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> W <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: W ;a vy O°1 1\a-- c r-ct 1 V\ ( • <br /> Applicant's Mailing Address: q a C oa Rd n!�(ry W i. 5 30 4 <br /> City State zip <br /> 2 y r <br /> Applicant's Telephone Number: 7/,S- ,fip&- 44-0 ,7 a t <br /> 0 <br /> w <br /> Applicant's Email: i <br /> 00 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> ❑Letter ®Phone ❑Email ° <br /> 5' <br /> w <br /> Legal Description: <br /> N' 1 <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR q i <br /> Gov't Lot#: OR 1/4 1/4 O <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.* Q� <br /> Parcel#(24 digits): J <br /> Z �- <br /> Tax ID#(1-5 digits): �la'3t' 3 <br /> Property Site Address: S 6 Y^ t>5 <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 IS 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 /> Proposed Structure/Addition Use: R��o.,,& -7y 3 6 A�wk 0^ V.�o.J S c1 <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: r.. Tj,, e- Tc A Master Plumber: <br /> Anticipated Start Date: <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application-Rev 3/2016 <br />