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LAND USE PERMIT APPLICATION -Burnett County, WI a <br /> Permit Fees: - t ` N `� <br /> o' <br /> � a N <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwellin Princi al Building-Single Family $200 .7 0. <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwell in Princi al Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 o <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I E <br /> Accessory Structure-Commercial Cl &11) $200 Addition to Accessory Structure-Commercial Cl &Il $200 � -�- <br /> Deck/Stairs/Patios 1 $125 1 Gazebo WI Stat 59.692(Iv)) $350 0 <br /> Camping Unit $100 Fillin Gradin <br /> $150 <br /> Permit Extension Valid for one year-Onl l Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. v <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. Z� <br /> 'v <br /> Applicant Complete All Sections Below This Line o . <br /> Z <br /> Applicant's Name: JOANI I A, F ART W-M 1 ' <br /> Applicant's Mailing Address:d 7 14 0 5 COUNTY ROAD 14 W E65-TEIZ W( 5.8893 <br /> City State zip rnn b <br /> Applicant's Telephone Number: '715- 1416-0603. <br /> c y <br /> Applicant's Email: ioi��10.r1OSh ho+mat i .(_orvt o <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. 1 <br /> ❑Letter ®Phone ❑Email N w <br /> Legal Description: <br /> Lot#: CSM Vol.1l _Pg. e909 OR <br /> y <br /> 7. <br /> Lot#: Block#: Subdivision Name: OR = <br /> Gov't Lot#: OR SE 1/4 NvJ 1/4 k�J <br /> Section#:37 Town#: L O N Range#:1_W Town of: SC-OT1 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): 0-1—038 -ca-140 — 14 33-a -04-000-013000 <br /> Tax ID#(1-5 digits): 187141 z <br /> } <br /> H <br /> w <br /> Property Site Address#: 2 l y 05 <br /> Road Name: CC,0Utj-r4 PokD City: We s.-Te P_ <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: L5-bo <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building E <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio Ll Commercial Addition o <br /> ❑ Stairs ACC. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m C <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit E3Commercial Acc.Addition z Z c <br /> Proposed Structure/Addition Use: 5T 6P_N1,E 91)1LDt n16 <br /> (Nome/Cabin;Commercial Business:Bedroom:Deck:etc.) O <br /> cm <br /> Building Contractor: { <br /> Anticipated Start Date: 5eP i I t x.015 <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> 3 <br /> v <br /> x <br /> m <br /> A <br /> m <br />