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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Permit Fees: g ut <br /> DwellingfPrincipal Building-Single Family $300 Addition to Dwellin rind al Building-Single Famil $200 <br /> Dwellin rind al Building-Multi-Family $300 Addition to DwellingtPrincipal Building-Multi-Family $200 1 V <br /> CommerciaUIndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I <br /> Accessory Structure-Commercial Cl &11 $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> Deck/Stairs/Patios $125 1 Gazebo(WI Stat 59.692(lv)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. n <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. Q <br /> W <br /> m <br /> Applicant�t Complete All Sections Below This Line <br /> Applicant's Name: rr/ / �� f S c� /� o <br /> Applicant's Mailing Address: 02�`/ O A /1, <br /> City Stat zip rni G fl <br /> z <br /> Applicant's Telephone Number: -7/ 7 �b a 3 s o H '� <br /> Applicant's Email: Z2.1 S SS C ztc 'i•e 11 t' C�'1 a 1 <br /> � I'P dl r � p <br /> m <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. 1 <br /> -0 1 <br /> [:]Letter ZPhone ❑Email c 00 <br /> Legal Description: <br /> is JG c 0' j CrJ F s� �• <br /> oa _ <br /> Lot#: CSM Vol. Pg. OR <br /> . ) <br /> Lot#: Block#: Subdivision Name: OR a, � <br /> Gov't Lot#: OR 1/4 1/4Ju <br /> , �? <br /> Section#: Town#: N Range#: W Town of <br /> *Attach additional age iIneededfor lengthy description OR attach a copy ofthe deed OR attach tax system propertyPage. � <br /> Parcel#(24 digits): 1 <br /> n <br /> Tax ID#(1-5 digits): z� � <br /> Property Site Address#: a yy0 <br /> Road Name: A I11AI 6e"-e-n eA City:��c <br /> E <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:�7). <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patid� ❑ Commercial Addition <br /> ❑ Stairs NkAcc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> El Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition C <br /> Proposed Structure/Addition Use: -? A 3o , Ga ro.q e y N Z o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , 0!5 <br /> Contractor: Z eN <br /> Anticipated Start Date: /�/ —/� z00 o <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 4/2015 > �� <br /> m <br /> a <br /> m <br />