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LA1ND UNL YLH1Y111 AlrIMIUA11u1N — Burnett uountV, wt ci <br /> Permit Fees: <br /> a <br /> Dwellin 'Princi al Building-Single Family $300 Addition to DwellingVPrincipal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to ConrmerciaPlndustrial Building $200 O <br /> Accessory StructuWAddition to Ace.Structure $150 Bunkhouse $250 <br /> m <br /> Accessory Structure-Commercial C I&I1 $200 Addition to Accessory Structure-Commercial C I&I I $200 <br /> Deck/Stairs/Patios 1 $125 1 Gazebo Stat 59.692(l v) $350 0 1 <br /> < I <br /> Camping Unit $lOD 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 —S <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> m <br /> *Items riot listed above will be treated as accessory structures,such as:pergalas, landscaping, retaining walls. 2 <br /> r 2, <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: <br /> Applicant's Mailing Address: /,f ✓ ` Y" 4 kN �J l �> • <br /> Gi1v State Zip <br /> Applicant's Telephone Number:) <br /> Imo. <br /> Applicant's Emc �1 <br /> Entail. �Y�1l�, S�z'�VYu{l'-�lit�t� b <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. jam. <br /> ❑Letter ❑Phone [Email <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR d <br /> n <br /> Lot 4: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: o(Wdy)J 1 <br /> *Attach additional page if neededfor lengthy description OR attach a copy oI the deed OR attach taxsystem property page. <br /> QL <br /> A'� Y <br /> Parcel#(24 digits): 01 -om CO-16-Iq-5 06-00),-ov-,0oo ( ` <br /> I�a,a� ca <br /> Tax ID#(1-5 digits): <br /> Property Site Address <br /> Road Name: 0City: (� (� <br /> g <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> ❑ 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 <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition t4 133 <br /> �yy C <br /> Proposed Structure/Addition Use: (,�� �C1 ' 2 Z _ <br /> \., Homer bin:CommerctalBustnes.s;Bedroom:Deck;etc.) N <br /> QQ <br /> Building Contractor: f �� 'G�'r) - <br /> Iiiial C9 . <br /> Anticipated Start Date: ll olC <br /> SEFNA gM64 _ <br /> Burnett County, WI Land Use Appl a n -Rev 4/2015 <br /> SURNETTCOUN <br /> ZONING <br />