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LAND USE PERMIT APPLICATION— Burnett County, WI a _ <br /> N ^ <br /> n ~ <br /> Permit Fees: rg <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwellin Princi al Building-Single Family $200 O <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellingfPrincipal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 1� <br /> Accessory Structure-Commercial Cl &I 1) $200 Addition to Accessory Structure-Commercial CI &11) $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(l v)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only I Allowed) $100 S <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. <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:perolas, landscaping, retaining walls. <br /> b <br /> m <br /> Applicant Complete All Sections Below This Line _ S <br /> Alley z <br /> Applicant's Name: _ �,��,,�Cr' o <br /> Applicant's Mailing Address: Z!�'p n 51�T&4'�' a OF 9E "MWMA) <br /> City State zip <br /> Applicant's Telephone Number: �j�_ �7�-b�7� z <br /> a "V <br /> Applicant's Email: ; n 5 G A&y VA-16o.GQm o C) <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter t ❑Phone Email} o YQ <br /> Legal Description:�j4Z Jf&'5 �/�f.54/694 QlV Ot Y� �� lAlec w <br /> Lot#: CSM Vol. Pg. OR Jai / alk 9 LK Pct QCJr <br /> 3. <br /> Lot#: Block#:- VY/7 I®fO 9R r„ <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: ORAZA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* -� <br /> Q(00006T <br /> Parcel#(24 digits): (� - a � � �Q- ��'�9 -S �a �-,j d A00C)o <br /> n <br /> Tax ID#(1-5 digits): I/651 r' z <br /> Property Site Address#: � <br /> Road Name:- k4kic Ave City: L1-7/vo <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> 0 <br /> ❑ Stairs Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. AdI-C <br /> a---=�✓ <br /> ,l CPrposed Structtue/Addition Use: �/0 n(j 6 E INLY - SCE V&Aialt)CAC- Vr'1J:- <br /> (Home/Cabin:Commerci l Business;Bedroom;Deck;etc.) -m{ n <br /> B posed <br /> Contractor: 0A Ag tJ L)f <br /> w uuu <br /> / o3L Q ti <br /> Anticipated Start Date: f,L�J�f)/6 <br /> Page 1 of 4 [� <br /> Burnett County, WI Land Use Application —Rev 4/2015 <br /> F <br />