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LAND USE PERMIT APPLICATION— Burnett County, WI a C <br /> z R7 b <br /> y N <br /> Permit Fees ; vi <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellingfPrincipal Building-Single Family $200 C7 N�1 <br /> DwellingfPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> CommerciaMdustrial Building $300 Addition to CommerciaUlndustrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 1 <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &II) $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(lv)) $350 0 <br /> Camping Unit $100 Filling/Grading $150 ' ' 7� <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> o , <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. v <br /> m <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. '- <br /> *Items not listed above will be treated as accessory strictures,such as:pergolas,landscaping, retaining walls. <br /> Applicant Complete All Sections Below This Line <br /> Applicant's Name: /0 <br /> Applicant's Mailing Address: 7�t1l/7 Aja easS L /CDC (,. eL6166r tVZ' SV? !-3 1 <br /> City State Zip <br /> Applicant's Telephone Number: c y <br /> Applicant's Email: <br /> w <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> []Letter ❑Phone %Email <br /> Legal Description: M �/ Ni< �'/ S 2,C7 7_3 47 (1 <br /> Lot#: 3 CSM vol. 444'04. -a4.1. OR d <br /> y � <br /> Lot#: Block#: Subdivision Name: OR 1 <br /> � 1 <br /> Gov't Lot#: OR 1/4 1/4 Qj <br /> vr) 1 <br /> 7 <br /> Section#:-410 Town#:_3_7 4 N Range#: Ac, W Town of: C'V � <br /> q G <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Parcel#(24 digits): _07- 04- a- 61 - boo - 015600 w <br /> Tax ID#(1-5 digits): <br /> Property Site Address#: 7Y//7 ,� <br /> Road Name: N, &5.f ZAKe Re�Q City: ( (/y !<�,e l� <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> 0 <br /> ❑ Stairs )i( Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N S7 <br /> ❑ Permit Extension ❑ Gazebo–WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition <br /> f� n Z c <br /> Proposed Structure/Addition Use: / e r" 0 l M Z <br /> (No Cabin;Commercial Business;Bedroom;Deck;etc.) i--� <br /> ,p n / V t! u Y <br /> Building Contractor: Baty a tat&Itclr� 4Z 8 o C== <br /> T� �� m C vi <br /> Anticipated Start Date: J(4 l y 2 D/S ���] <br /> Page 1 of 4 c `._J <br /> Burnett County, WI Land Use Application—Rev 4/2015 <br /> 3 <br /> 2 <br /> m <br /> z <br /> m <br />