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LAND USE PERMIT APPLICATION - Burnett County, WI b <br /> y ^ 1 <br /> rn r <br /> Permit Fees: 5 <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellinglPrincipal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellingfPrincipal Building-Multi-Family $200 rn <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) E <br /> Addition to Acc.Structure $150 Bunkhouse $250 fli <br /> Accessory Structure-Commercial CI &Il) $200 Addition to Accessory Structure-Commercial Cl &Il $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> (Screen arches-in campgrounds only) $125 Gazebo WI Stat 59.692 lv $350 r <br /> Camping Unit $100 Filling/Grading $150 o <br /> Permit Extension Valid for one ear-Only1 Allowed $100 Boathouse $500 C' <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. P. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. b <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: ,red Mailing Ad ss: 7 OY�k /3�4 <br /> � 1,&J <br /> , /g//V (S_M <br /> � ro <br /> City State zip # <br /> Applicant's Telephone Number: S-1. <br /> Applicant's Email: c5f e�►r��Q�R 14leil/YIQa �Q (1�t(( ►�(/�� f (l(jh/l o <br /> ro <br /> If staff has a question about this„ap cation how do you prefer to be contacted? Check one below. N <br /> 59L p��� Lett SE] hone Email 5 <br /> OQ <br /> Legal Description: wwwVVVIII <br /> N <br /> Lot#: CSM Vol. Pg. OR 5' <br /> Lot#: Block#: Subdivision Name: OR F <br /> Gov't Lot#: OR 1/4 1/4 , e <br /> Section#: Town#: N Range#: W Town of. y <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 digits): <br /> � z <br /> Tax ID#(1-5 digits): <br /> Property Site Address: �ULI <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: LZ2�x <br /> ❑ Single Family Dwelling Cl Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> Cl Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio Cl Commercial Addition <br /> ❑ Stairs A 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 C <br /> M <br /> Proposed Structure/AdditionUse: nfo /J U)W" 't(L /a/ �� m z <br /> (H me/Cab'n; 7mercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: � YVi �..i <br /> �tjr Master Plumber: O <br /> p o <br /> Anticipated Start Date: Q Z s <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 3/2016 �� <br />