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V <br /> LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> U <br /> Permit Fees: <br /> a <br /> Dwellin Princi al Building-Single Family $300 Addition to Dwell ing/Principal Building-Single Family $200 <br /> J <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwellin Princi al Building-Multi-Famil $200 �, <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> O <br /> Accessory Structure/Addition to Ace. Structure $150 Bunkhouse $250 l <br /> Accessory Structure-Commercial C I &11 $200 Addition to Accessory Structure-Commercial Cl &11 $200 a <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692 lv $350 O <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year Only 1 Allowed $100 <br /> 0 <br /> *NOTE:After-Ihe-fact(when no permit is obtained prior to construction)is three times the normal Tee. <br /> a <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> *Items not listed abore will be treated as accessory structures, such as: per olas, landscaping, retaining walls. <br /> Applicant Complete All Sections Below This Line o . <br /> z <br /> Applicant's Na me AAj),e� 4Te�rVO" (-F_ L (SCS\ UI <br /> Applicant's Mailing Address: q905- D / a <br /> City j State Zip U �j <br /> Applicant's Telephone Number <br /> r <br /> Applicant's Email: cxhhe4tie�, gy c (14LOO , Caq b <br /> II-staff has a question about this application how do 'you efer to be contacted? Check one below. v <br /> ❑Letter �yone ❑Em``ai_l1� <br /> Legal Description: A(�(� kQ ,��5 l.CG a t <br /> Lot#: CSM Vol. Pg. OR b <br /> c w <br /> Lot#: 320 Block#: Subdivision Name:An hMCcrr a 6 5�0�KOR <br /> Gov't Lot#!—OR 1/4 1/4 <br /> 1 <br /> Section#: Town#: N Range#: W Town of: Ste}- � I <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach lax system property page.* y <br /> Parcel #(24 digits) <br /> r <br /> Tax ID#(1-5 digits): 7� 3 <br /> z <br /> Property Site Address#: I 4,p7G <br /> Road Name:_1_6n Q � P ( �i City: I DwY\ UJ S� <br /> T F <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 ' <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure 1 <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition 8i <br /> Proposed Structure/Addition Use: �±GYYN t, /CQ Z c <br /> (Home,'Cabin;Commercial Business;Bedroom:Deck:etc.) 4.0 <br /> Building Contractor:- LSD � C� <br /> Anticipated Start Date: Si?/tTC.yY� 6P, 00/5 Sven ei" )'Jevt� n /1� vel �"��1 RO <br /> R C s+ <br /> Page I of 11 Y U <br /> Burnett County, WI Land Use Application-Rev 4/2015 <br />