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LAINL? USE FERAU I AFFIAC:A1'WiN — Burnett Uounty, WI <br /> Permit Fees: a' n tj► <br /> Dwdli /Princi Builth -Single Fmily 5300 Addition to Dwdli /Princi al Building-Si le Family $200 zx a <br /> Dwelli ci Buildina.Multi-Family $300 Addition to Dwelli Rvinci al Building-Multi-Family $200 R <br /> Ie <br /> Commcrcid&drsttial Building $300 Addition to Commercial/industrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $1511 Bunkhouse $250 <br /> Accessory Structure-Commercial(Cl&Il) 5200 Addition to Accessory Structure-Commercial CI&I1) $200 <br /> DeeldStairslPatios $125 Gazebo WI Stat 59.692(1%,)) $&50 <br /> e <br /> Camping Unit $100 Fiilli /Gra i o $150 <br /> r <br /> Permit Extension(Valid for one vear-only 1 Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is Owte times the normal fee. m <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. • <br /> *dems not listed above will be treated asacceszory strtictures,such as:pergoLas,landscaping,retaining watts. <br /> ro <br /> n <br /> Applicant Complete All Sections Below This Line . <br /> z <br /> Applicant's Name: T2�f V 0.11 Ce- <br /> clQs f v i <br /> Applicant's Mailing Address: 5v, yt• 5 1p 4 K ki �5 O <br /> i <br /> ON State Zip <br /> Applicarif s Telephone Number: <br /> v ;? <br /> Applicant's Email: Q `tiR +f!`�10o, Cal N1 8 <br /> If staff has a question about this application how do you prefer to be contacted? Check otte below. <br /> �1CI.etter Phone Email o <br /> Legal Description: 0 A ri —-1 333 c) loo <br /> 1 oo <br /> Lot#: .3 CSM Vol. 3 Pg. _31 OR „7 <br /> S. <br /> Lot#: Block#: Subdivision Name:_ OR 0 <br /> Gov't Lot#. a OR 1/4 1/4 /V <br /> Section 33 Town#:__y 0_N Range#:^ _W Town of. <br /> *Attach additional page ij needed for lengthy descnpd on OR attach a copy of the deed OR attach tar system property page.• y <br /> Parcel#(24 digits): 07 - 0.2O -2-40 —16-33-5 PS-00;Z -015000 1 <br /> d <br /> Tax ID#(1-5 digits): <br /> I3�3 � z _ <br /> Property Site Address#: a7146`1 <br /> Road Name: 5+0Mhart•t city: IM6-->4er <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec* <br /> N(Singie Family Dwelling ❑ Multi-Family Dwelling ❑Filing/Grading Cl Commercial Building � <br /> ❑Single Family Addition ❑ Multi-Family Addition ❑Deck/Patio ❑Commercial Addition <br /> ❑Staits �Acc.Structure(Non-bunkhouse) L3 Bunkhouse ❑Commercial Acc.Structure N <br /> ❑Permit Extension ❑ Gazebo-WI Stat 59.692(Sv) ❑Camping Unit ❑Commercial Acc. Addition <br /> evvte <br /> � C <br /> Proposed StnicturaAdditionUse: H � �g <br /> (Heme/Calxn:Comnzernd Bueiwss:Bearoom,Deck:&c.) N Z l7 u u <br /> o <br /> Building Contractor. CanS1 N�" f'+� L LCt Ht�t t-✓4�+� t J - Z � <br /> ,t- <br /> Anticipated Start Date: — y —I S __..._- S�G)C) �J tr u <br /> Page 1 of 4 6 C �" <br /> Burnett County,W 1 Land Use Application-Rev 4/2015 <br /> it <br />