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LAND USE PERMIT APPLICATION - Burnett County, WI ° 3 ro <br /> Permit Fees: ? <br /> Dwelling/Principal Build -Single Famil $300 Addition toDwellin /Princi al Buildi -Single Famil0 a- <br /> Dwellingftincipal Building-Multi-Family $300 Add itionto Dwellinincl alBwldi -Multi-Famil 0 <br /> CommerciallI dustrial Building $300 Additionto Commercial/Industrial Building 5200 = <br /> Accessory Structure/Addition to Ace.Structure $I50 Bunkhouse $250 £O <br /> Accessory Structure Commercial C I&1 l) $200 Additionto Accessory Structure-Commercial C I&1 I $200 <br /> Deck/Stairs/Patios $125 Gazebo IStat59.692(ly) $350 l�I <br /> Cam n Unit $100 Filling/Grading $150 g I C) <br /> Perm it Extension Valid for one year-Onl I Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. -5�r <br /> *Communication Towers&Signs require a different AWplication fort, see corresponding applic•ceion aril fees•. <br /> */terns not listed above will be trecued ea ixcesson•stna•nrres.such as:pergolay. landscaping. retaining w(dls. ?. <br /> Z <br /> Applicant Complete All Sections Below This Line v S- <br /> j� J _1 I I^ <br /> Applicant's Name: Q ( ( �_ )LA�01 P� ao& �)C)k n C-7J�( , 1 I _ r 3 <br /> z <br /> Applicant's Mailing Address: I SLId 39 <br /> (9t-� 3(- nwo MI N212C, <br /> City State Zip <br /> Applicant's Telephone Number <br /> 3 <br /> I <br /> Applicant'sEmail:V-)k lt�i! 2"Aaaro Qn a- <br /> If staff has a question about thisapplication how do you prefer to be contacted? Check one below. <br /> Letter hone Email <br /> Legal Description: -, rko 11, <br /> Lot# CSM Vol. Pg. OR �' <br /> Lot#: Block#: Subdivision Name: OR ) <br /> GoJtLot#: OR SE 1/41/4 <br /> Section#: J Town#: _ g J+ JP t <br /> N Ran a#: W Town of: <br /> *A trach additiond page if needed for lengthy description OR mach a copy of the deed OR offacklar system prpeny page. <br /> I <br /> Parcel #(24 digits): <br /> Tax ID#(1-5 digits): ()Q <br /> Property Site Address#:-1�3 6 <br /> z <br /> Road Name: :s,, a^� City: f <br /> TYPE OFPEMUMS):Cheek appropriate box/boxes Fee Reo- —.00 <br /> q Single Family Dwelling q Muki-Famtly Dvefng q Filling/Grading q Commercial Building <br /> Sttgle Family Addtinn q MutFFatmly Addition q Deck/PatioCommercialq Commercial Addition i <br /> q Stairs q Ace.Structure(Non-bunkhouse) q Bunkhouse q Commercial Acc.Structure 1n <br /> 0 <br /> q Permit Fitensnn q Gazebo- WI Stat 59.692(ty) q Camping Unit q Commercial Acc.Addition `° <br /> C <br /> Proposed Structure/AdditionUse: <br /> (Horne/Cabin;Commercial Business;Bedroom;Deck;etc.) Z -,uM �:;u ti <br /> Building Contractor. 9--4 1-- <br /> C) <br /> --o <br /> Anticipated Stott Date: A C <br /> paue l (W5 M Z f <br /> Burnett Countv, WI Land t?se Application - Rev 1 2016 <br /> �S <br />