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LAND USE PERMIT APPLICATION — Burnett County N1'I a b <br /> y <br /> Permit Fees: <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family P$200 <br /> `/1 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building <br /> AccessoryStructure/Addition to Acc.Structure $150 <br /> AccessoryStructure-Commercial Cl &II $200 Addition to AccessoryStructure-Commercial Cl &Il) <br /> Deck/Stairs/Patios $125 Gazebo WI Star 59.692(l v)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. n <br /> *Communication Towers&Signs require a different application form,see corresponding application andfees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. <br /> •o <br /> ro <br /> Applicant Complete All Sections Below This Line <br /> (/ o <br /> Applicant's Name: be.r, &uJ� e <br /> Lt <br /> .n <br /> K t <br /> Applicant's Mailing Address: 6 I k XeA-0, La/t P& &ekn 1 AAA 6vqL <br /> City State Zip rni <br /> Applicant's Telephone Number: nn o y x <br /> Applicant's Email: A&A K� O jU L j e, r-oA,,% d v <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter Phone Wmail N °° <br /> Legal Description: L a-P*a S KTr/+ !�I�.. ►ton e� g a l ' <br /> Lot#: CSM Vol. Pg. OR oin <br /> 5. <br /> Lot#: Block#: Subdivision Name: 'J I��/�i/k���tnalf�. OR r„ <br /> Gov't Lot#: OR 1/4 1/4 <br /> bSection#: Town#: N Range#: W Town of: 7tLG�(se� I <br /> *Attach additional page i needed or lengthy description OR attach a co o the deed OR attach tax system property page. <br /> P8 f .l gY P copy Y P P tyPg <br /> Parcel#(24 digits): <br /> Tax ED#(1-5 digits): n z <br /> d � <br /> Property Site Address#: 1.1 it e1pQ{ea•7• " " r� <br /> Road Name: S � A '} 1\r� City: �0.CdvSeA 7 ulK 5 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:a_qs,(D <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition X Deck/Patio ❑ Commercial Addition y <br /> d <br /> ❑ Stairs Acc. Structure(Non-bunkhouse) Bunkhouse ❑ Commercial Acc. Structure N <br /> LlPermit Extension 11Gazebo—WI Stat 59.692(ly) ❑ Camping Unit L3Commercial Acc. Addition 2 C <br /> Proposed Structure/Addition Use:��q C p"*,* Sked <br /> Z n <br /> me/Cabin;Commercial Business;Bedroom:Deck:etc.) � v <br /> Building Contractor: �t1n. K"eoQ� r� <br /> uu II � N <br /> Anticipated Start Date: k5040 -['1-Ve CC rn <br /> Page 1 of 4 ma <br /> Burnett County,WI Land Use Application—Rev 1/2016 <br /> m <br /> a <br /> m <br />