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LAND USE PERMIT APPLICATION — Burnett County, WI a c <br /> a• - �o <br /> y y.1 <br /> Permit Fees: 0 to <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 ' <br /> v <br /> CommerciaVlndustrial Building $300 Addition to CommerciaVlndustrial Building $200 0 <br /> Accesso Structure/Addition to Acc.Structure $150 Bunkhouse $250 1 0 <br /> Accessory Structure-Commercial(Cl &Il) $200 Addition to.Accessory Structure-Commercial Cl &Il $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(l v)) $350 o <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. a <br /> d <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. = <br /> *Items not listed above will be treated as accessory stnictures,such as:pergolas, landscaping,retaining walls. <br /> m � <br /> Applicant Complete All Sections Below This Line <br /> � z <br /> Applicant's Name: J ,ice + A/Af" !!!h. L AAil <br /> Applicant's Mailing Address: J DA (o g) {ANO ✓ S a • , L A w f ri aZ <br /> City State Zip 9 <br /> _ 3 <br /> Applicant's Telephone Number: bfl oZ O b7 Z o <br /> 6 <br /> Applicant's Email: J W LAelcl 07 6) �0 1� MAi f C'.�• ^p <br /> w <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. vSU <br /> ❑Letter ®Phone ❑Email N <br /> o� <br /> 0 <br /> Legal Description: e I M►. LAyw P pi tS LU 2- Lo I I <br /> Lot#: CSM Vol. Pg. OR r <br /> y <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 �(v <br /> 0 <br /> Section#: Town#: N Range#: W Town o£ tNo +j � <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): 67— G/8 - a' 34 ✓ <br /> C� <br /> Tax ID#(1-5 digits): 1A(P ( l d <br /> Property Site Address#: .?S'a/ ti H d <br /> Road Name: DAWtca.at &W f— City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: ����a) <br /> Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> m <br /> ❑ Stairs cc. Structure(Non-bunkhouse) El Bunkhouse ❑ Commercial Acc. Structure N � <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition z tv G•� <br /> n C <br /> Proposed Structure/Addition Use: I;J,6 Z <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> FiR <br /> Building Contractor: LG 9nt IJ.r" on_ �.ArzK��L�C.oN� � <br /> -20 ry c=3 <br /> 0 <br /> Anticipated Start Date: C <br /> Page 1 of 4 c <br /> Burnett County,WI Land Use Application—Rev 4/2015 a <br /> 3 <br /> x <br /> m <br /> a <br /> m <br /> 1 <br />