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LAND USE PERMIT APPLICATION- Burnett County, WI a ro <br /> Ny <br /> Permit Fees: c ut <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 C <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 1 <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &Il) $200 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.69200 $350 c 1 <br /> Camping Unit $100'lfting/Grading CD <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 0 <br /> n, fined pr&to cons o� times the normal fee. v V <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. 2 <br /> ro <br /> m <br /> Applicant Complete All Sections Below This Line <br /> 0 <br /> Applicant's Name: <br /> Applicant's Mailing Address: L —! 1 j�Qa(f Q _ onin W Z <br /> 4e9k1-w 101St ?JV-Q.C r0LUeL —7oi�rjl.++D j7ly LN 30-7 City State zip Z <br /> Applicant's Telephone Number: 9-7 0 <br /> c � <br /> Applicant's Email:T51014ha V k <br /> \J rn <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. SL <br /> ro I <br /> Letter Phone ❑Email N <br /> 0 <br /> Legal Description: w. L <br /> Lot#: CSM Vol. 2- Pg. OR o <br /> y <br /> n <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#:-2— Town#:_ N Range#: W Town of: DEW P�f <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 <br /> Tax ID#(1-5 digits): 373 <br /> z <br /> �6 y Iro <br /> Property Site Address#: <br /> Road Name: D x e -c 1 kf,- City: t, 1 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: Ua•o'D <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling .Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y l <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m C=am <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition <br /> ('' <br /> Proposed Structure/Addition Use: m <br /> (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) <br /> O L5 C1 <br /> Z W <br /> Building Contractor: c <br /> � ^ o <br /> aW <br /> Anticipated Start Date: N �� 13— <br /> Page 1 4 <br /> Burnett County, WI Land Use Application-Rev 4/200 15 <br /> 3 <br /> 'v <br /> x <br /> m <br /> a <br /> m <br />