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LAND USE PERMIT APPLICATION -Burnett County, WI 9 <br /> :5. <br /> N ~ <br /> Permit Fees: a ?� <br /> Dwellin rinci al Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 a <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwellin ci al Building-Multi-Family $200 1 <br /> Commerciallindustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 ( )1 Q <br /> Accessory Structure-Commercial Cl &I1 $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> Deck/Staim'Patio/Retaining Wa1VSidewalk/Driveway& $ <br /> Screenporches-in campgrounds only) $125 Gazebo WI Stat 59.692 lv $350 r <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension(Valid for one year-Only 1 Allowed $100 Boathouse $500 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. 9 <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. `D <br /> o ' <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: DDUALAS P l_1f1JlER <br /> Applicant's Mailing Address: $353 rn-q! L-P�( KE Co[. A&. IJ ro <br /> City State Zip c .. <br /> Applicant's Telephone Number: to 1Z,— cl g& — Ljj fL <br /> Applicant's Email: QWLn0Leros y 0 Avg //{,& D. Gc7w% � 1 <br /> ro <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N w 1 <br /> ❑Letter hone ❑Email a '� <br /> w <br /> Legal Description: C <br /> m <br /> Lot#: CSM Vol. Pg. OR 5. m <br /> Lot#: Block#: Subdivision Name: ,(VONCE PAiZK OR o <br /> Gov't Lot#:4_OR-1/4 1/4 1 <br /> Section#:—A'Town#:_if_I_N Range#: t(A W Town of SWtS S <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax.+ystem property page. <br /> m <br /> Parcel#(24 digits): <br /> n z <br /> Tax ID#(1-5 digits): <br /> y <br /> Property Site Address: o2lWO(P TGATE RO 35' Swt%TWW- til l 54830 <br /> c <br /> TYPE OF PERMrr(S): Check appropriate box/boxes Fee Rec: ��o <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/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 C <br /> Proposed Structure/Addition Use: CShg#&E5, M �z <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 0 Z/fl D <br /> Building Contractor: KEN t k,,{ - Master Plumber: Z <br /> Z N' <br /> Anticipated Start Date: /M," lS. ZDKO G)0 o <br /> Page 1 of 4 Z <br /> Burnett County,WI Land Use Application—Rev 3/2016 4 (- —) <br />