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LAND USE PERMIT APPLICATION— Burnett County, WI a b <br /> Permit Fees: , n to <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal 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 Commercial/industrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 1 <br /> Accessory Structure-Commercial(Cl&11) $200 Addition to Accessory Structure-Commercial(Cl &11) $200 � <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59-692(lv)) $350f0 L <br /> Camping Unit $100 Fillin 'Gradin $150 !�� <br /> r <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. <br /> *Communication Towers&Signs require a different application form, see corresponding application and fees. t`t7 eT <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. 5 <br /> Applicant Complete <br /> �All"Sections Below This Line C o <br /> pp <br /> A licant's Name: <br /> Applicant's Mailing Address: 2 F,6 /b 1. I zl W r// d <br /> City State Zip ro <br /> Applicant's Telephone Number: o ti <br /> ` J <br /> Applicant's Email: o <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ro <br /> []Letter one ❑Email <br /> Legal Description: �� r� Me S i�c f 1 �(�c $ w� J 0 <br /> Lot#: CSM Vol. Pg. OR ° 1 <br /> Lot#: Block#: Subdivision Name: OR r„ 1 <br /> Gov't Lot#: OR 1/4 1/4 4 <br /> 1 = v <br /> Section#: —7 Town#:Lt� N Range#: �6 W Town of: <br /> *Attach additional page ifneededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* �J <br /> r � G <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> Property Site Address )_ <br /> Road Name: rL � a r �o ret ��1 City: �C).Y'�,/ ( <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:),OOr be <br /> Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ,Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> e <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> N <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ty) ❑ Camping Unit ❑ Commercial Acc.Addition 0 <br /> Proposed Structure/Addition Use: /wr pn y <br /> (Hoo Cahin;Commercial Bus mess;Bedroom:Deck,-etc.) <br /> Building Contractor./_^ /— <br /> NZ <br /> Z � r <br /> Anticipated Start Date:��� Z O <br /> Page 1 of 4 g f7 C <br /> V Burnett County, WI Land Use Application—Rev 4/2015 <br /> i � <br />