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r <br /> LAND USE PERMIT APPLICATION— Burnett County, WI <br /> .. <br /> Permit Fees: <br /> a W <br /> Dwelling/Principal Building-Sin Ie Family $300 Addition to Dwellin rind al Building-Sin le Family $200 � C7 <br /> rn. <br /> DwellingtPrincipal Building-Multi-Famil $300 Addition to Dwelling/Principal Building-Multi-Famil $200 � O <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial Cl &II) $200 Addition to A cessory Structure-Commercial CI &11) $200 1 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(lv)) $350 c <br /> Camping Unit $100 Filling/Grading $150 — <br /> Permit Extension Valid for one year-Only 1 Allowed $100 c <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 /> ro <br /> Applicant Complete All Sections Below This Line o <br /> z <br /> Applicant's Name: 131 LL ANNA Qts RNND <br /> Applicant's Mailing Address: J 90 COUGH Aa SUPOlog, W. 10*,PQ <br /> City State Zip <br /> � z <br /> Applicant's Telephone Number: 71,5-- 3 Q 2- 44064m o y <br /> c <br /> Applicant's Email: o <br /> d <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> Wetter ❑Phone ❑Email N 00 <br /> Legal Description:_ -pee— Z)Q�- Ch-eA-., <br /> Lot#: CSM Vol. Pg. OR o <br /> 1 <br /> Lot#: Block#: Subdivision Name: OR y I <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: �'CCST 1 <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): <br /> X <br /> ( digits): ids " z <br /> Tax ID# 1-5 <br /> Property Site Address#: _ <br /> Road Name: Sw I-s"s TRAIL City: <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 X Deck/Patio ❑ Commercial Addition N <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure o <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition z <br /> z �"/d <br /> -3 u _ _ <br /> Proposed Structure/Addition Use: l(,( {' �� m Fn^f '' <br /> cn <br /> (Home/Cabin:Commercial Bus ness;Bedroom; ;etc. Z m <br /> 1� f <br /> Building Contractor: :1 � <br /> Anticipated Start Date: OCT I ACIX T Q C�g^ <br /> Page1 of 4 o Z <br /> Uuu <br /> Burnett County,WI Land Use Application —Rev 4/2015 <br /> 3 <br /> o <br /> x <br /> m <br /> A <br /> m <br />