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LAND USE PERMIT APPLICATION—Burnett County, WI 7 3 c <br /> = b <br /> Permit Fees: <br /> Dwelling Principal Building-Single Family $300 Addition to D%%elling Principal Building-Single Family $200 <br /> Dwelling Principal Building-Multi-Family $300 Addition to Dwelling Principal Building-muhi-Famil $zoo <br /> Commercial/Industrial Building $300 Addition to Commercial Industrial Building $200 <br /> Accessory Strucmre(Non-Bunkhouse) N E <br /> Addition to Ace.Structure <br /> $150 Bunkhouse $250 - <br /> Accessory Structure-Commercial(C l&11) $200 Addition to Accessory Structure-Commercial W 1&1 I) $200 <br /> 0 1 <br /> Deck/Stairs Patio,Retaining Nb-alVSidewalkDriveway& � <br /> (Screenporches-in campgrounds only) 5125Ga7ebo(W I Stat 59.692(l v)) 5350 <br /> Camping Unit $100 Filling!Grading 5150 <br /> Permit Extension(Valid For one year-Only I Allowed) 1 $100 Boathouse s500 0 <br /> "NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. �' n <br /> *Communication Towers&Signs require a different applic•arion farm,see corresponding application and fees. 7 <br /> `Items not listed above trill be treated as accessory structures,such as:pergolas.landscaping,etc. n <br /> o <br /> Applicant Complete All Sections Below Tlds Linc \ o _ <br /> Applicant's Name: r6VF� koo mmt&la WWPLJLIt� l� <br /> Applicant's Mailing Address: '50 MYRTLE moo W, WN12ATlk M IJ 553`(1 <br /> City State Zip (�h <br /> Applicant's Telephone Number: Q52 4"i 3,'1 q <br /> Applicant's Email: rn 5 briayvln (3 YY15Vl .00m o <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> Letter ❑Phone Email <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR n <br /> Lot#: 1N I+1 Block it: Subdivision Name: or � � E i <br /> Gov't Lot#: OR 1/4 WW I/4 k1bo01-J4i'�' <br /> -f 1 —I li I <br /> Section#: 2 T Town#: 3g N Range#:�$ W Town of:_WOOD (Z.1UFQ I <br /> •A Hach additional page if needed for lengrh)•description OR attach a cope of the deed OR attach rar.r).atem property-page.• �� <br /> Parcel#(24 digits): 01.042•1Z•38 • 1%-Z7.5 15. 5$Lf- 61-1000 <br /> Z 1 <br /> Tax ID#(1-5 digits): 29 518 r x <br /> 4 <br /> Ilwn tort'h �hctt. L)Ae, <br /> Property Site Address: , &wV15LUM Wl <br /> c <br /> J <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: e�� <br /> El Single Family Dwelling ZI Multi-Family Dwelling El Filling/Grading ❑ Commercial Building <br /> Single Family Addition 7 Multi-Family Addition ❑ Deck/Patio ❑Commercial Addition <br /> ❑ Stairs :1 Acc.Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc.Structure <br /> Cl Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑Camping Unit ❑Commercial Acc.Addition C—=� <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wall Cl Sidewalk/Driveway <br /> Proposed Structure/Addition Use: Ron" RMI' . A.WrC &d!! e, 0 Z <br /> (Home/Cabin;Commercial Businers:Bedroa .Deck:ere.) <br /> Building Contractor: Qh t Cu-t C105trOChtm Master Plumber: 1.I.d. • Z exp el u tf <br /> Z 0 <br /> Anticipated Start Date: tOt br1 E t 1201 +�C V <br /> —� Page 1 of 4 Z 0-)f <br /> Burnett County, WI Land Use Application-Rev 3/2016 <br />