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LAND USE PERMIT APPLICATION -Burnett County, WI b <br /> y wr <br /> Permit Fees: <br /> m � <br /> a <br /> Dwelling/Principal Building-Single Familv $300 Addition to Dwelling/Principal Building-Single Family $200 O t' <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building,-Multi-Famil $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 C <br /> Accessory Structure/Addition to Ace.Structure 5150 Bunkhouse $250 t <br /> Accessory Structure-Commercial Cl &11) $200 Addition to Accessory Structure-Commercial(Cl&11 $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692 Iv $350 <br /> n o <br /> Camping Unit $100 Fill in /Gradin $150 » <br /> Permit Extension Valid for one year-Only 1 Allowed 0$100 I» i <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. ` w <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. 70 <br /> v <br /> Applied Comp4ete Ail SWW=W=BelloWIN4 lf' r <br /> � o <br /> �f t z <br /> Applicant's Name: S+e'yCn KQ'�b I+e.e ri I TGC I <br /> Applicant's Mailing Address: 3�2 3 &_X-W i C.C. 1-<"-a 45syq3 I VJ <br /> City State zip J <br /> Z <br /> Applicant's Telephone Number: 3 14�c4 I �O 1 0 <br /> F <br /> r. <br /> Applicant's Email: ST£ICAT O'7 (0 CO w1Ca,9-F • 1)e o � <br /> Lp <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter DQPhone ❑Email c <br /> Legal Description: 36 go ins OL <br /> Lot#: CSM Vol. I pg. 103 OR <br /> a. <br /> Lot#: Block#: Subdivision Name: OR T <br /> Gov't Lot#: I —OR-1/4 1/4 I�Uj <br /> o <br /> Section#:3_Town#: G{O 111 N Range#: 15-W W Town of: J0.ei-SO 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ) <br /> Parcel#(24 digits): - O I Z - 2- 4 0=!S-3 b -5 S `OO I - O 1 (o Opp <br /> Tax ID#(1-5 digits): f00 C{ z <br /> Property Site Address#: <br /> Road Name: PO.YI t n S tl kQ Rd City: W e'b S e 1'— <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:au 4 oo <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑Commercial Building <br /> u <br /> 2S Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑Camping Unit ❑Commercial Acc. Addition <br /> 1 <br /> Proposed Structure/Addition Use: &&r 00 t1ns +1` C <br /> ^ ' (H_ommelCahin;Commercial Business:Hedroom:Deck:etc.) C tt� <br /> Building Contractor: y VaY h� LCT CO n a4Yttc_4S O IVO -ty <br /> p Oct0/S — ECEVE Zn l :, <br /> Anticipated Start Date: <br /> Page 4 fl© t <br /> Burnett County, WI Land t Rep�fi&"FiRev 2 5 1i-7;3j <br /> BURNETT COUNTY <br /> ZONING <br />