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LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> y. rn <br /> Permit Fees: "1 to <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellingfPrincipal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaUIndustrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I <br /> Accessory Structure-Commercial Cl &11) $200 Addition to Accessory Structure-Commercial Cl &II $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(lv)) $350 c 1 <br /> Camping Unit $100 Filling/Grading <br /> $150 <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 <br /> 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. cn <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 /> Applicant Complete All Sections Below This Line c <br /> Applicant's Name:;V/; <br /> Applicant's Mailing Address: j /a� IVPg0It4 �K'""' � �cOlj�P�, Zur <br /> City State zip <br /> Applicant's Telephone Number: <br /> — c <br /> Applicant's Email: C7 <br /> w <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. Sul <br /> 1 <br /> i <br /> F1 Letter 'hone ❑Email c <br /> Legal Description: se e <br /> Lot#: CSM Vol. Pg. OR o <br /> N <br /> Lot#: Block#: Subdivision Name: OR a, <br /> Gov't Lot#: OR�,1/4 Al 4 1/4 E <br /> Section#: Town#: _N Range#:—!Y W Town of: U S <br /> *Attach additional page ifneededTor lengthy desertPtion OR attach a copy of the deed OR attach tax system propertyPage.* W y <br /> Parcel#(24 digits): <br /> ( digits): <br /> Tax ID# 1-5 _ <br /> Property Site Address#: 2-70 IE_ y <br /> Road Name:W, p i-L Lali e City:\�,fQ6 4eir— <br /> � may, <br /> TYPE OF PERMIT(S): Check appropriate box/boxes F(,� <br /> LlSingle Family Dwelling El Multi-Family Dwelling L3Filling/Grading L3Commercial Building Fee Rec!--41; <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition 5 <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 CDQ <br /> n C <br /> Proposed Structure/Addition Use: p r fZ <br /> > o <br /> (No a/Cabin;Commercial Business;Bedroom;Deck;etc.) +� 0 <br /> 0 <br /> Building Contractor: 6e -10 j _Z <br /> Z 0 r� <br /> Anticipated Start Date: S bo h 5 P OS S/A i2 m G) <br /> Page 1 of 4 c Z <br /> Burnett County, WI Land Use Application —Rev 4/2015 > �' <br /> b <br /> M <br /> rr <br />