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LAND USE PERMIT APPLICATION - Burnett County, WI � c <br /> ro <br /> Permit Fees: ' <br /> a <br /> DwellingfPrincipal Building-Single Fan-dl $300 Addition to Dwelling/Principal Building-Single Family $200 ;` O <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwelling/Principal Building-Multi-Famil $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 O <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 t = <br /> Accessory Structure-Commercial Cl &11) $200 Addition to Accessory Structure-Commercial(Cl &❑) $200 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692(l v)) $350 rc <br /> Camping Unit $100 Fillin Gradin $150 <br /> Permit Extension Valid for one year-only 1 Allowed) $100 c <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 /> Mems not listed above will be treated as accessory structures,such as:pergolas,landscaping,retaining walls. <br /> �e <br /> Applicant Complete All Sections Below This Line _. <br /> �DAA.)5 D.E./ z <br /> Applicant's Name: /� o`C. c <br /> Applicant's Mailing Address: 13 97 7 Y? 27n : mer JV S T/f i'vgrCy., M AJ 512.8 <br /> City State Zip <br /> � z <br /> Applicant's Telephone Number: 43 1 qq 7 <br /> c <br /> m <br /> Applicant's Email: A) OAA) S Li 3 q 4p 6-,IJ77A1l , GI okn o <br /> w <br /> i9 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter E4Phone ❑Email N w <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR o `j <br /> Lot#: // Block#: Subdivision Name: pr :S OR <br /> y <br /> Gov't Lot#: OR 1/4 1/4 03C7 <br /> 0 1 <br /> Section#: p t Town#:ALN Range#:1S-_W Town o£ 5 Lt)l S S 1 <br /> *Attach additionalpage if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* 3 <br /> V 1 <br /> Parcel#(24 digits): 0'7-03.2 -a- y/ ^/5-04-5" /5-O(n(e -0/3600 <br /> � e <br /> z <br /> Tax ID#(1-5 digits): <br /> 1 <br /> Property Site Address#: 5 150 <br /> Road Narne:__Bur I I S fire i City: <br /> � J <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee ReccjL0 <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m W <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition Z D <br /> Proposed Structure/Addition Use: Z <br /> (Home/Cabin• ommercial Business:Bedroom;Deck:etc.) � <br /> n o <br /> Building Contractor: o c: <br /> Anticipated Start Date: Z u u u <br /> Page 1 of 4 0 �/ <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> x <br /> m <br /> a <br /> m <br />