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LAND USE PERMIT APPLICATION — Burnett County, WI a c <br /> ,Permit Fees: 0 <br /> 6 <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> DwellinglPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 m <br /> B <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 c`` <br /> X� <br /> AccessoryStructure-Commercial Cl &11) $200 Addition to AccessoryStructure-Commercial Cl &Il $200 � � I <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692(]v)) $350 o <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. m (A <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 /> ti O <br /> Applicant Complete All Sections Below This Line �'� �. R <br /> Applicant's Name: JM n GJ May/e- b <br /> Applicant's Mailing Address: 3051.5 In Yt 11A LZA dew <br /> City State Zip <br /> �7 ( z <br /> Applicant's Telephone Number: /�1- <br /> Applicant's Email: <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. �U <br /> ❑Letter RPhone ❑Email N w <br /> 0 <br /> Legal Description: t <br /> w <br /> Lot#: CSM Vol. Pg. OR <br /> H <br /> A <br /> Lot#: Block#: Subdivision Name: OR r„ <br /> Gov't Lot#: OR 1/4 1/4 F <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage.* -3 <br /> Parcel#(24 digits): ! <br /> Tax ID#(1-5 digits): n z <br /> Property Site Address#: 3 i /J <br /> Road Name: / r!T!i 1 A k l� City: PVbiV 'Y <br /> f <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:atQ•Oa <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> J�Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> ❑ Stairs Ll Acc. Structure(Non bunkhouse) El Bunkhouse ❑ Commercial Acc. Structure o <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition z C <br /> � Z <br /> Proposed Structure/Addition Use: A? 2 r- <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Cc D <br /> �-+ <br /> Building Contractor: I�U W.v 6,0,01/j/DG J)d h 0 OD 2� <br /> m0 oN LV <br /> Anticipated Start Date: dS mZ <br /> �� <br /> Page 4 c4 <br /> Burnett County,WI Land Use Application — Rev 4//200 15 <br /> 3 <br /> 0 <br /> x <br /> m <br /> A <br /> m <br />