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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> Permit Fees: ] E <br /> Dwellin 'Princi al Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 ky <br /> Dwellinerincipal Building-Multi-Family 00 Addition to Dwellin Princi al Building-Multi-Family 5200 rt <br /> Commercial/Industrial Building $300 Addition to Commercial/industrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 —� t <br /> Accessory Structure-Commercial Cl &11 $200 Addition to Accessory Structure-Commercial(Cl &I1) $200 SO <br /> r1 <br /> ~ L�1 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.G92(Iv)) $350 0 l <br /> Camping Unit $100 Fillip Gradin $150 -� <br /> r <br /> Permit Extension Valid for one year-Onl IAllowed) $100 ° <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee, in <br /> *Communication Towers&Signs require a differcon application form,see corresponding application and fees. 2 <br /> *Items not listed abote will be treater(as accessary shuctures,stick as: et- olas,landsca in ,retaining walls. <br /> ro �-- <br /> m <br /> Applicant Complete All Sections Below This bine o <br /> z <br /> Applicant's Name: TO CL_� .y Y-1> <br /> Applicant's Mailing Address: 3 1X1.0 C L_44YT 3: s C_CnLnncryl /Ziv S PW <br /> City State Zip ro <br /> Applicant's Telephone Number: 9sz- <br /> Applicant's Email: CA Q71\_I�\o I%jwoo V Q 4,Ai eA- d <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> [-]Letter ❑.Phone <br /> ❑Email 0 t <br /> Legal Description: N wyq <br /> Lot#: - CSM Vol — Pg. — OR <br /> Lot#: Block#: - Subdivision Name:---- OR n t I <br /> Gov't Lot#: OR_ J\)Lo 1/4 A) �0 1/4 g <br /> t � � <br /> Section#: d1_15 Town#: 3 S' N Range#: W Town of: 2,6?t Grjj <br /> 11e_ 'f✓ <br /> '"Attach additional page if needectfor lengthy description OR attach a copy ofthe deed OR attach lax system property page. <br /> I <br /> Parcel#(24 digits): oe-)s As- c%e2_00-bill (h CJ�_..--_ m C <br /> F <br /> q c zcJ <br /> Tax ID#(1-5 digits): <br /> 2 ,/ N <br /> Property Site Address#: 3 77 <br /> Road Name: & U,n City: S �q 4Z, <br /> TYPE OF PERMIT(S): Check appropriate box/boxes T Fee Rec:3z�iD, <br /> Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building - <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition H <br /> O Stairs ❑ Acc. Structure (Non-bunkhouse) ❑ Bunkhouse ❑Commercial Acc.Structure io <br /> C❑ Permit Extension ❑ Gazebo-WI Stat 59.692(iv) ❑ Camping.Unit ❑ Commercial Acc. AdditionZ o,lProposed Structure/Addition Use: )4-cm � »► M <(H ne/Cabin:Comneerciat Bariness:Beb-oonu Deck:enc.) U u Y <br /> ((�^ ] TBuilding Contractor: CG 1J�✓17Y ",) oQ � YY1 � ` S G�/ / "'Sl V�.-L - l- C <br /> Anticipated Start Date: t / 7 �J <br /> Page 1 of 4 <br /> Burnett County, WI Land Use Application-Rev 4/2015 <br /> z <br /> F. <br /> ;1 <br />