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LAND € SE PERMIT APPLE IMON a Burnett County, W,I a <br /> y � <br /> Perrnit tees: a Lit <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family 5300 _ AdditionitrDwelling/Princi-alBuilding-Multi-Family - 5200 <br /> Com+ner,ia}P}ndnstnal nliiao 9300 Addition to Commercial/IndumnalBILA-fines P,200 <br /> Acc c, SW-a �fAv3,C n'c mac.S aehie <br /> $25ff [ <br /> Accessory Structure-Commerciar Ci &i i' 5200 Addition to Accessory Siruciwe-Cononercia} 'Ci &ii' $200 <br /> Dusk/StairsTatios $125 Gazebo Wt Stat 59-692 1 yjj $350 o' <br /> Cainping Unit $100 Filling/Grading Filling/Grading $150 <br /> I Permit Extension(Valid for one year-On} ]Allnwed) $lou <br /> 12 <br /> *NEITE ARS r tl fal t lwhm,no nQrmu is ght ad prior to conclrtsctrtutl is tkrce t me¢the ai r� fie: ]] { <br /> *('nmmnvi+rafiinta Tncxrwg k Qsc c raiur�n a d!ffirmnr a rcartor foror, <br /> see fX1r't'e�p^ r'g af3p1'3rPfiaP nxd fear, � 1 <br /> *hems not lfsaed above rz{ &tneatedas acc ,,c,y ,:tMdre, such us.Y .bor.,, r -d-.�.re,. ! ..b .Kns <br /> . <br /> 3 <br /> taipglic �irftz A11 ct ;�e.,u`€'hts�yA� � c <br /> L <br /> Applicantrn <br /> Applicants Mae: tq.R7 /4^}JP /—,A) D s>F 1-{6 4C"JZ_ <br /> Applicant's Nlaihng Address: <br /> City Stoic dip <br /> Applleants 'vi'a p nCtti nt rr: < r <br /> w <br /> �'` ' ry i <br /> ,A-"hiant5 LIIIQ 1: I V ko Lt e w� olfa l <br /> YY <br /> } <br /> CZ <br /> I i staff has a question about this application how do you prefer to be Contacted? Check one below. <br /> [Letter [hone OF-mail <br /> Legal DGscrjintlton. <br /> Lot CSM Vol. Pg. OR l <br /> T rf <br /> ui fi: u: c.,u1u—uiv r.s.iorNam;: �f���-� OR <br /> Gov't Lot#: 5 (o OR 1/4 1/4 �� o <br /> Section#: _To"..#: 1`;Ramie#: (,o W Town of t 5 S <br /> 1 { <br /> *Attach additionalpage if needed for lengthy description OR attach a copy of the deed OR attach tax system praperiy page- <br /> Parcel t!(11-4 disks) '•-• [—' Imo' <br /> Tax1D#0-sdigitsY�_ zz.7^yO Sc: as7'1l �Z I i� <br /> pc�rrle--rht site Address#; 77 41 <br /> Road Name: W44 it Ce-A-� e ' City:_ 1 4_AJ X17" <br /> TYPE OF PERMIT(S).Cheek approprieft box/boxes <br /> U Sir,family Dw--I i{tg ll Mttltt-Faff*Dwell+n9r►Ft .IG cradling r ee nee. r <br /> c�xr+ercial+�.�lding <br /> Single Lamily Addition Muth-Famih Additiorrr ,`r'at o Ct3m tl��iof;droit <br /> L! Stairs Melr_c.Structure(Non-bunkhouse) u Bunkhouse EJ Commercial Acc.Structure o <br /> LlPermit Extension Ll Gazebo—Wi Stat 59.692(ly) O Camping Unit LlCommercial Acc.Addition C <br /> cl Z <br /> Proposed Structure/Addition Use: :540P e4D D,Utak) F:p)& 5-jV AA G<_f- tl N m e r= <br /> 5 <br /> (Flonre/Cabuz Commercial i3trerrtess;Bedroom DeDeckztcO m,) '� <br /> Building Contractor- 1<6 00 Gt4LG C TION tYittL&C K Z n <br /> G)0 o <br /> Anticipated Start Date: FAIL 20IS Z <br /> Page 1 of 4 <br /> Burnett County, W1 Land Use Application—Rev 4/2615 <br />