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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> h y <br /> Permit Fees: <br /> 6 l <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellinglPrincipal Building-Sin a Family $200 d <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 r <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 -- <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $2S0 <br /> Accessory Structure-Commercial C 1&I l $200 Addition to Accessory Structure-Commercial C I&I l $200 a p <br /> Deck/Stairs/Patios $125 Gazebo Star59.692ly $350 0 <br /> 0 <br /> Camping Unit $100 Filling/Grading <br /> Permit Extension Valid for one year-Only I Allowed $100 0 <br /> =NOTE:After-the-fact(when no permit is obtained prior to eftstruction)is three times the normal fee. <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. <br /> nowb <br /> r <br /> 0 <br /> Applicant's Name: V1 In AAJD R e R 13A N C 21— <br /> Applicant's <br /> 1 -Applicant's Mailing Address 14)AkZ2tJ rIND elle-.. MfV Sd ¢dff �1 <br /> CityState Zip <br /> � z <br /> Applicant's Telephone Number: &/2 — <br /> Applicant's Email: 13AeWa-7T . 3 K CDa 1"14 , n zA a <br /> d <br /> w <br /> iP <br /> If staff has a question about this application how do you prefer tobe co cted? Check one below. v l <br /> ❑Letter ❑Phone mail ro <br /> N <br /> 0 <br /> Legal Description:_ — f/77;4 C/4E) <br /> Lot#: CSM Vol. Pg. OR b <br /> 5 _l <br /> Lot#: Block#: Subdivision Name: ORUj <br /> a <br /> Gov't Lot#: OR 1/4 114 <br /> l <br /> Section#: Town#: N Range#: W Town of. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. y i <br /> 1 <br /> Parcel#(24 digits): _ r, <br /> m <br /> Tax fD#(1-5 digits): z <br /> Property Site Address <br /> Road Name: 7Tn1�cy Stc— x _ City: - <br /> TYPE OF PERMIT(S): Check appropriate box/boxes <br /> Fee Rec: S® <br /> ❑Single Family Dwelling ❑ Multi-Family Dwelling ❑Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ AAStructure(Non-bunkhouse) ❑ Bunkhouse ❑Commercial Acc. Structure <br /> ❑ Permit Extension WGazebo—WI Stat 59.692(ly) ❑Camping Unit ❑Commercial Acc.Addition <br /> Proposed Structure/Addition Use: /)t G JK <br /> (Home/Cabin;Commercial Business;Bedroom,;Deck,;etc.) <br /> Building Contractor:_ 9,r��LL — C�DitJ 7iU� Ln <br /> r/ <br /> Anticipated Start Date: <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Applicatim <br />