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LAND USE PERMIT APPLICATION — Burnett County, W1 a b <br /> Permit Fees: a vi <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwellin rinci al Building-Sin le Family $200 <br /> Dwellin rinci al Building-Multi-Famfl $300 Addition to Dwellin Princi al Building-Multi-Family $200 /_ <br /> CommerciaUIndustrial Building $300 Addition to CommerciaVlndustrial Building $200 V') <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 , <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &Il) $200 JV�� <br /> Deck/Stairs/Patios 1 $125 1 Gazebo(Wl Stat 59.692(Iv)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> r <br /> Permit Extension Valid for one year-Onl IAllowed) $100 ° <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. n <br /> w <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 /> m <br /> Applicant Complete All Sections Below This Line - <br /> Rabe,e7 S>/�oryc z <br /> Applicant's Name: �7 9 ' � <br /> Applicant's Mailing Address: I p/ VV Liao�x�04L Sl7mwex zc�r 59m <br /> City State zip <br /> Applicant's Telephone Number: G3n✓r' 7y�1/� o <br /> Applicant's Email: �/"!STic j0AOSS/ 1��i O.�'OYl1 0 <br /> w <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> av <br /> ❑Letter ❑Email o I <br /> Legal Description: a eel <br /> Lot#: CSM Vol. Pg. ORW' I o <br /> Lot#: Block#: Subdivision Name: Id(()a � ' J 1 rv' Tdt I1 <br /> Gov't Lot#: OR 1/4 1/4jj <br /> F <br /> Section#:_ Town#: N Range#: W Town of: <br /> 1 <br /> *Attach additional page if needed fohy description O attach a copy of the deed OR attach tax system property page.* 1 <br /> Parcel#(24 digits): <br /> z d <br /> Tax ID#(1-5 digits): y � <br /> Property Site Address#: ((,�� LF I o y <br /> Road Name: City: <br /> F <br /> TYP"F PERMIT(S): Check appropriate box/boxes Fee RecIED• <br /> Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building E <br /> N <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> L3 Permit °z � <br /> Permit Extension Gazebo-WI Stat 59.692(iv) ❑ Camping Unit ❑ Commercial Acc.Addition � W � <br /> n C <br /> p G,a,e,�%e- > <br /> Proposed Structure/Addition Use: � > <br /> (Name/Cabin;Commercial Business;Bedroom;Deck;etc.) Z <br /> Building Contractor: jZ <br /> Q <br /> Anticipated Start Date: ( V o_ <br /> Page 1 of 4 0 <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> m <br /> A <br /> m <br />