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LAND USE PERMIT APPLICATION—Barnett County,WI <br /> Permit Fees: <br /> Xtil/ <br /> Dwtlfir,Vi'nnci al Building-Sin=leFami] $300 Addition toDwelling lkmc alBui{din -Sin leFamil $200 e <br /> Du I—I lPrinci al Building-Mull!-Family 5300 Addition to Dwelling2rincipal Building-Multi-Pamil $200 n <br /> Cemmtrri:d/l❑dusty al <br /> Building $300 Addition to Commercial/Industrial Building $200 �. <br /> Accessory,S[rueture/Addition to Ace.Straeture 5150 Bunkhouse $250 \ �� <br /> u <br /> Accessor•ntrueture-Commercial(CLLUL 11 5200 Addition to Accessa Structure-Commercial Cl&Il $200 <br /> DecUStairRatios $125 Gazebo Stat 59.6921v $350 <br /> Ct;m to t nit $100 Fillin radio $150 <br /> Permit Ext:osion(Valid for ono ear-Only 1 Allowed $100 <br /> NOTE:AfleT-thc-Pact(when no permit is obtained prior to construction)is three times the normal ice. <br /> *Comm,:mcation Towers&Signs require a different application form,see corresponding application and fees, <br /> Z <br /> 'Items 71,1 listed above will be treated as accersory siruerures,such as:pffgolat,landsc ,in retaining wall$ <br /> Z <br /> Apphca-tits Name, J UG.ir1* <br /> Applicant'1 Mailing Address: ( a TOLI S pl6aeMQ/ k1L <br /> City State Zip r <br /> Applicant's Telephone Number 1 b -S" 49l <br /> r, <br /> Applicant's Email; S'Aplu! bee1110 A .4 P'' - A)Ff �a <br /> If staff has a question about this application how do you prefer to be contactcd7 Check one below. � V <br /> ❑Letter MR= []Email o <br /> Legal Des,mr6on: 1 <br /> LOT ii:__1 CSM vol. ti Pg._a0 opp �r <br /> Lot#: Block#: Subdivision Name: D p 5 L f e 5 OR ce <br /> Gov't Lot#: OR IA_114 '4- <br /> Section :-S�Town#: `�11L N Izange#: is I��1 Town of: <br /> I <br /> •Attach adr'rtional page ifneeded for lengthy description OR attach a copy of the deed OR attach tax system prapedy page.• �1 �� I�� <br /> Parcel#(i4 digits), 0 � Iz � <br /> n <br /> Tax ID H(1-5 dtgits):^ Il 5' <br /> Property Sire Address#_ l7c a g ' <br /> P.oad Narrc i!r S Tr l City: P/ctt -u I <br /> TYPE OF PERMIT(S):Cheek appropriate box/boxes Fee Ree:__ <br /> *Single:Family Dwelling ❑ Multi-Famlly Dwelling 0 Filling/Grading 0 Commercial Building <br /> O Single;Family Additlon ❑ Multi-Famlly Addition 0 Deck/Patio 0 Commercial Addition <br /> (1 Bunkhouse ❑Commercial Acc.Structure <br /> D Star_ Q Acc. Structure(Non-bunkhouse) � <br /> 0 permit Extension ❑ Gazebo–WI Stat 59.692(1v) D Camping Unit 0 Commercial Acc.Addition <br /> C(A Yl W <br /> Proposed:;[ructurc/Addition Use: $, 5 <br /> (Rome/Cabrh;Commercial Business;Bed>aam;Oecr;;etc.) , <br /> NZ c <br /> Building(ont:ractore �' Z ZIr <br /> Anticipatel Start Date:_a� o�O�rP Z 0 <br /> Page I of 4 O O o <br /> asurnett County,WI Laud Use Application—Rev 1/2016 Z �' (� <br /> }aap a: i [od iam0018 WUl� O� 9l ? <br />