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LAND USE PERMIT APPLICATION — Burnett County, WI g <br /> y <br /> Permit Fees: °, in <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 G <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaVlndustrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial Cl&❑ $200 Addition to Accessory Structure-Commercial Cl &Il $200 a <br /> Deck/Stairs/Patios $125 Gazebo I Stat 59.692(l v)) $350 <br /> Cam in Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one yearL Only 1 Allowed $100 <br /> 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. �' 0, <br /> *Items not listed above will be treated as accessorystructures,such as:pergolas, landscaping,retainingwalls. �! J <br /> W <br /> Applicant Complete All Sections Below This Line S . <br /> o <br /> Applicant's Name: Rodney Gieser <br /> Applicant's Mailing Address: 28814 Ninth Green Ln Danbury WI 54830 <br /> City State Zip <br /> Applicant's Telephone Number: 715-259-7813 0 <br /> Applicant's Email: o <br /> d <br /> fi <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter XPhone ❑Email M I <br /> b <br /> 0 <br /> Legal Description: Lot 4 CSM 2118 V 12P29 5' <br /> Lot#: 4 CSM Vol._l2 P9._29 OR 9 'S <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#:_2_OR 1/4 1/4 o <br /> Section#:_18 Town#:_40 N Range#:_l4 W Town of. Scott <br /> *Attach additionalIxige ifneededfor lengthy description OR attach a copy of the deed OR attach tax systemproperty p g .* y <br /> Parcel#(24 digits): 07-028-2-40-14-18-5 05-002-012000 <br /> 1 <br /> Tax ID#(1-5 digits): 18173 n z <br /> Property Site Address#: 28814 <br /> Road Name: 9th GeedlLn City: Danbury <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: /—ZSD. ( f <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs X Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazeta—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition C <br /> Proposed Structure/Addition Use: Shed n�V m D <br /> ( Home/Cabin;Commercial Business:Bedroom:Deck;etc.) :II— <br /> aaaccc cintl uOY <br /> Building Contractor: Northland Builders Inc o r� <br /> 0 <br /> Anticipated Start Date: 5/18/2015 Z <br /> Page / 4 d <br /> Burnett County,WI Land Use Application—Rev 4/200 15 <br /> T. <br />