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PZ <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> N <br /> Permit Fees: a ?� <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwellin g,Princi al Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> CommerciaVlndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Ace.Structure $150 Bunkhouse $250 ` g <br /> Accessory Structure-Commercial(C 1 &11) $200 Addition to Accessory Structure-Commercial(C l &11) $200 I <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& ° 1 <br /> (Screen orches-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 /> m <br /> g <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. �d <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. <br /> 0 3 <br /> 1�Applicant Complete All Sections Below This Line o <br /> Applicant's Name: SPY <br /> Applicant's Mailing Address: Po COX 2 7 0 cf3 i 51-- 1'AVS. M M lJ 512- 7 � � <br /> City State Zip C <br /> Applicant's Telephone Number: 12— �d l ( � Hy a <br /> Applicant's Email: C-0/V1 a <br /> I <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N 0° <br /> ❑Letter ❑PhoneEmail <br /> Legal Description:_&OV i-OT (p E;X CSM C7 10 A1 .9 d <br /> N <br /> Lot#:c CSM Vol. 10 Pg, 2__ OR 1 <br /> Lot#: Block#: Subdivision Name: OR o i <br /> f i <br /> Gov't Lot#: OR 1A 1/4 <br /> Section#: -10 Town#:qy N Range#: _W Town of: .5Co TT <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): 7 � 2 2O ' 05 - 00(4p— O 1 boo <br /> n z <br /> Tax ID#(1-5 digits): I S'3 3 Lj <br /> Property Site Address: 2(&OCD O tit< <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: 15 <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs A Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(iv) ❑ Camping Unit ❑ Commercial Acc. Addition CD <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway _—J <br /> I <br /> Proposed Structure/Addition Use: �. R�i��. N Z I,(Home/Cabin;Commercial Business;Bedroom;Deck:etc.) O <br /> Z <br /> Building Contractor: 5t_:. , IN 5 P 1 4c, J4UP1e P64aster Plumber: O O N <br /> Anticipated Start Date: C=C <br /> Page 1 of 4 <br /> I Burnett County,WI Land Use Application—Rev 3/2016 0 <br /> c <br />