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• 1 <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a _ <br /> y ^ 1 <br /> Permit Fees: c tit <br /> �• <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 O <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellinglPrincipal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 O <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 \ <br /> Accessory Structure-Commercial Cl &Il $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> Deck/Stairs/Patios 1 $125 1 Gazebo WI Stat 59.692(]v)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only I Allowed) $100 <br /> 0 <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:pergolas, landscaping, retaining walls. <br /> b <br /> // yApplicant(C�omplete All Sections Below This Line <br /> Applicant's Name: `A f L^ k n A tr <br /> C <br /> Applicant's Mailing Address: / ! t: k< La <br /> City State zip <br /> -7/s- e�� - < <br /> Applicant's Telephone Number: / 484 Z <br /> a y <br /> c d <br /> Applicant's Email: <br /> d <br /> >v <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. I ' <br /> ❑Letter ❑Phone P§Email t c w <br /> Legal Description: S 47S ©4 564o of WINS a a� SW A S[� <br /> Lot#: CSM Vol. Pg. OR o <br /> w <br /> a <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 o <br /> Section#: "7 Town#: -31 N Range#:-I W Town of: 4e.,n CII <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax.system property page.* a <br /> Parcel#(24 digits): o7 - 01R- 7, -37-1(P-07-3 63 occn - o i3Oop w v <br /> Tax ID#(1-5 digits): f 3 CO � z <br /> Q I <br /> Property Site Address#: U04Z4. +g l a e bt e4 1 w f • } <br /> Road Name: �a&«R r CC 'S rd City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: 30 O <br /> t*Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure to <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition31 e <br /> 11 _ Z o <br /> Proposed Structure/Addition Use: <br /> ft'�H'IR ---- <br /> (Home/Cabin:Commercial Business:Be <br /> Cr.)NE <br /> Building Contractor: O o <br /> ®C �„ MAY 31 2016 p c <br /> Anticipated Start Date: �af� m <br /> ,gURp COUC 1 of 4 U <br /> Burnett County, WI Land se � 4/2015 y <br /> 3 <br /> s <br /> S <br /> M <br /> X <br /> M <br />