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LAND USE PERMIT APPLICATION—Burnett County, WI g b <br /> Permit Fees: a to <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Famil <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial 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 CI &Il) $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(l v)) $350 oz o <br /> Camping Unit $100 Filling/Gradin $150 <br /> Permit Extension Valid for one year-Only l Allowed) $100 <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 /> Applicant's Name: uflen �n /.J � <br /> Applicant's Mailing Address: <br /> —� City State zip CCA <br /> Applicant's Telephone Number: <br /> c <br /> m <br /> Applicant's Email: d <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. b I <br /> [-]Letter Phone ❑Email N l <br /> 0 <br /> Legal Description: \ 1 <br /> Lot#: CSM Vol. Pg. OR / v <br /> Lot#: Z Block#: Subdivision Name: 8 U o4 k ve5 /s t flea/ OR <br /> 1 <br /> Gov't Lot#: OR 1/4 1/4 0 <br /> f <br /> Section#: Town#:—V -N Range#: W Town of: L.9/S S 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 /> z <br /> Tax ID#(1-5 digits): jr'' � � <br /> Property Site Address#:5n Q <br /> Road Name:R C.�r�l City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:a00 <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling �❑ Filling/Grading Ll Commercial Building s <br /> Single Family Addition El /Multi-Family Addition CI Deck/Patio ❑ Commercial Addition N <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition C <br /> Proposed Structure/Addition Use: rrrrrrZ��� o <br /> �� (Home/Cabin;Commercial Business:Bedroom:Deck;etc.) r� C <br /> ~ i1 tt I7 <br /> Building Contractor: -Z O <br /> p oo y- <br /> �+ / o (:jigAnticipated Start Date: -� / /�7 ���/� C Ln t t <br /> Z UUU <br /> Page 1 of 4 0 ---� <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> b <br />