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LAND USE PERMIT APPLICATION - Burnett Countv, WI a <br /> Permit Fees: 0 cn <br /> a <br /> Dwelling/Principal Building-Single Fan-dl $300 Addition to Dwellin rinci al Building-Single Family $200 G <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellinglPrincipal Building-Multi-Family $200 <br /> m <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Accessory Structure or Bunkhouse $250 <br /> Accessory Structure-Commercial(Cl &Il) $200 Addition to Accessory Structure-Commercial(Cl&Il) $200 <br /> Deck/Stairs/Patios $125 Gazebo WlStat 59.692(lv)) $350 c <br /> Camping Unit $100 Filling/Grading $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. v <br /> m <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 /> v <br /> Applicant Complete All Sections Below This Line c �. <br /> Z <br /> l O <br /> Applicant's Name: e r 1 e, i h e '/ <br /> Applicant's Mailing Address: C e. t T 54 S3 6 <br /> City State Zip <br /> �v51 233 3970 z <br /> Applicant's Telephone Number: o y � <br /> 1 c <br /> Applicant's Email: 60Lhe 1Y0Q2r 55' @ gmai ( . corn d G <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> Lette OEPhone ❑Email 09 <br /> $EsW S36-T41N-RIbW PCLS Sd of Town ROJ € 14 OL I pia.+ of &u i( LAke LNDNG a -. <br /> Legal Description: ' (LIL( LANE) �5- Fes ' l <br /> Lot#: CSM Vol. Pg. OR G <br /> N <br /> A <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR Cj E 1/4 S w 1/4 <br /> 1 � o <br /> Section#: 3 6 Town#: 4 I N Range#:��W Town of: S W►S 5 <br /> f the deed OR attach tax system property additional age if neededfor lengthy description OR attach a copy * r <br /> I <br /> Parcel#(24 digits): 07-632-2-yi - Ib -36 -s 04' 000 - 011000 <br /> `I � <br /> Tax ID#(1-5 digits): Z 2-1"1 3 0 z <br /> Property Site Address#: A­1:�er <br /> Road Name: To W er City: SUv/SS <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 /> ❑ Stairs JR( Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m <br /> L] Permit Extension LJ Gazebo–WI Stat 59.692(ly) 13 Camping Unit L3 Commercial Acc.Addition Z C <br /> n11 <br /> Proposed Structure/Addition Use: S+'O r&qe./$1101 N Z v <br /> z <br /> (Home bin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: nO&e–r� r <br /> O o <br /> Anticipated Start Date: MeV 1-o i <br /> 2 10 1,j m C J <br /> Page 4 0 <br /> Burnett County,WI Land Use Application-Rev 3/2015 <br /> 3 <br /> 9 <br /> S <br /> m <br /> a <br /> m <br />