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,iia.:• ,•u. . <br /> LAND USE PERMIT APPLICATION— Burnett County, WI L m- <br /> o N �1 <br /> Permit Fees: a ?� <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to CommerciaUIndustrial Building $2004- <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I ; <br /> Accessory Structure-Commercial Cl&II $200 Addition to Accessory Structure-Commercial Cl &Il $200 <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(Iv)) $350 c t <br /> Camping Unit $100 Filling/Grading $150 <br /> r <br /> Permit Extension Valid for one year-Onl 1 Allowed) $100 <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: er olas,landscaping,retaining walls. <br /> •v <br /> Applicant Complete All Sections Below This Line <br /> Applicant's Name: Kenne- y1 14 6''0 k6;516 )� 9 <br /> Applicant's Mailing Address: 71�a5- Old3P �fY by J5�f�')7?7 <br /> City State Zip cl� c�} <br /> c3 z <br /> Applicant's Telephone Number: 7/5 '377 255(0 o H '� <br /> c <br /> 6 <br /> Applicant's Email: o <br /> d <br /> io <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. i <br /> �/yy ❑Letter ,Phone ❑Email N °G <br /> Legal Description: R-L. �)W l� SO3q/y R17�/ ' <br /> Lot#: CSM Vol. Pg. OR o I <br /> N <br /> "1 <br /> Lot#: Block#: Subdivision Name: OR F, <br /> r„ l <br /> Gov't Lot#: OR 1/4 1/4 f 1 <br /> 1-3 <br /> Section#:11 Town#: 3ql N Range#: I W Town of: Li NGp(0 0 1 U ' t°� <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): n7•f�t'(p'a - (7 �- O�J �(��' (� (.�(� <br /> Tax ID#(1-5 digits): 'U(0 n z <br /> Property Site Address#: <br /> Road Narne:- Drk)m L kwot City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:30 8 <br /> A Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building � <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m <br /> ❑ Permit Extension ❑ Gazebo-W/IISStar SQ f,Q7110 ❑ CAmoinq Unit ❑ Commercial Acc. Addition i-=--� <br /> C <br /> Proposed Structure/Addition Use: <br /> 7o n �U <br /> ( <br /> Hom <br /> e <br /> /Cabin <br /> ,-Camw&cialBusiness;Bedroom;Deck;etc.) � m � <br /> Building Contractor: W <br /> 0 <br /> 1 t—� <br /> Anticipated Start Date: `f ' <br /> C _3 <br /> Page 1 of 4 I; Z <br /> Burnett County,WI Land Use Application-Rev 1/2016 <br /> M <br /> A <br /> M <br />