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LAND USE PERMIT APPLICATION — Burnett Countv, WI r <br /> w <br /> Permit Fees: °c <br /> DwcllingIPtincipal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 G <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> CommerciaUlndustrW Building $300 Addition to Commercial/Industrial Budding $200 v <br /> Kccessoty Structure/Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial CI&11 $200 Addition to Accessory Structure-Commercial Cl&11 $200 q <br /> Deck/Stairs/Patios $125 Gazebo Stat 59.692 tv $350 <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 S <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. <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,retaining walls. <br /> Applicant Complete All Sections Below This Line <br /> z <br /> 0 <br /> Applicant's Name: Rose Bauman-Doug Brown <br /> Applicant's Mailing Address:-28520 Kilkare Rd Danbury WI 54830 <br /> City State Zip ro <br /> Applicant's Telephone Number: 715-651-0350 0 <br /> Applicant's Email: northland001@centurytel.net a <br /> !a <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter ❑Phone X Email <br /> Legal Description: <br /> Lot#: 1 CSM Vol._2 Pg. 206 OR o <br /> Lot#: Block#: Subdivision Name: OR l)) <br /> Gov't Lot#� 7 OR SE 1/4_SW 1/4 <br /> Section#: 13 Town#: 40 N Range#:_15 W Town of Jackson I <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* y <br /> J <br /> Parcel#(24 digits):_07-012-2-40-15-13-5 05-007-011000 1 <br /> Tax ID#(1-5 digits): 5477 r) z <br /> Property Site Address#:_28520 y ` <br /> Road Name: Kilkare Rd City: Danbury hJ ' <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:1!RLrX <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ���❑(((Multi-Family Addition L3Deck/Patio LJ Commercial Addition <br /> L3 Stairs ,l\Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> Ll Permit Extension /❑ azebo–WI Stat 59.692(iv) Ll Camping Unit LJ Commercial Acc. Addition OD <br /> Proposed Structure/Addition Use: Addition to pole shed Z `;! ° u <br /> (Nome/Cabin;Commercial Business;Bedroom;Deck;etc.) m <br /> Z o <br /> Building Contractor_Northland Builders Inc Z bo _ <br /> SG)® NC <br /> Anticipated Start Date: 11/16/2015 o <br /> Page 1 of 4 20 z <br /> Burnett County,WI Land Use Application—Rev 4/2015 C� <br /> Y. <br />