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LAND USE PERMIT APPLICATION—Burnett County, WI r <br /> a � <br /> 1 < = ro <br /> y - 1 <br /> Permit Fees: <br /> a61 <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellingfPrincipal Building-Single Family $200 a <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to DwellinglPrincipal Building-Multi-Famil $200 ^' <br /> ry <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 a <br /> Accessory Structure-Commercial CI &11) $200 Addition to Accessory Structure-Commercial CI &Il $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(l v)) $350 0 ) <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. n <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> */tems not listed above will be treated as accessory structures,such as:pergolas, landscaping, retaining walls. <br /> 'o <br /> Applicant Complete All Sections Below This Line o . <br /> '/ z <br /> Applicant's Name: Ak" LLIrs0Q ba&,/f! KQA � (Son-," - law) o <br /> Applicant's Mailing Address: 1Y39 /mark Sk AJhik- Behr Ll kt MN SS//a <br /> City State Zip <br /> z <br /> Applicant's Telephone Number: t(p 5_1 J 6 5_3- j/0g / (&51 ) 2 70- Q 127 <br /> c <br /> Applicant's Email: ka h l d c� S-fi 1 1 wc�4-er 5 c b oo I s . ©ra o <br /> w <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. SU <br /> /s ❑Letter ®Phone []Email N <br /> 00 <br /> Legal Description: �GI, L7p�erntv��.} Lp f 2 ! Sec.. q T 4l9 N fZ I'f 14 �' T <br /> 0 <br /> Lot#: CSM Vol. Pg. OR o ) <br /> y <br /> 7. <br /> Lot#: Block#: Subdivision Name: OR r„ <br /> Gov't Lot#: 2 OR 1/4 1/4 f Q) <br /> Section#: 9 Town#: 40 N Range#:_1y W Town of: SCo+i- <br /> *Attach additional page ifneededfor lengthy description OR attach a copy of the deed OR attach tax system propertyPage. <br /> r <br /> Parcel#(24 digits): 07 - 02-8 -2 - YO - N- 09 --5 05- 002 - O/3000 <br /> Tax ID#(1-5 digits): <br /> N <br /> Property Site Address#: 29�ZS <br /> Road Names'."- 6rr � City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> El Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit Ll Commercial Acc. Addition Z M <br /> Z c <br /> Proposed Structure/Addition Use: <br /> (Home/Cabin;Commercial Business:Bedroom;Deck;etc.) v <br /> n r.3 <br /> Building Contractor: bents F1i 9e jute o O cS <br /> C v, <br /> Anticipated Start Date: Fa-4' 20/S` �Z u u u <br /> Page 1 of 4 0 <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> a <br /> 9 <br /> S <br /> m <br /> z <br /> m <br />