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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> a• <br /> N ^ <br /> y N <br /> Permit Fees: g c� <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwellin rinci al Building-Single Family $200 C <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwelling/Principal Building-Multi-Famil $200 g <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 t <br /> Accessory Structure-Commercial(Cl &I1) $200 Addition to Accessory Structure-Commercial(Cl &11) $200 SL) <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692 lv) $350 0 ` <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only] Allowed) $100 <br /> 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. v <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. <br /> ro <br /> Applicant Complete All Sections Below This Line <br /> '` z <br /> Applicant's Name: b xV 1 O �f+\ S `K/� ( e <br /> Applicant's MailingAddress:_Z(.59 L� L- � V few �QIU��JQf 1 LQS sgoz <br /> City State zip <br /> `` ro <br /> Applicant's Telephone Number: S -t 2S CA 1 a o # <br /> c C3 <br /> Applicant's Email: s 10 cal 0 6 GL_� k d <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ro t <br /> ❑Letter ❑Phone Email 11 09 <br /> Legal Description: Q 0.G W 20 S+Q r 5c(8 qTT <br /> ' <br /> Lot#: CSM Vola( to Pg. 2(08 (seee 0:HMCkQ A) o <br /> y <br /> Lot#: Block#: Subdivision Name: OR -� Cn <br /> o <br /> Gov't Lot#: OR 1/4 1/4 <br /> ��l I <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 alta tax system property page. <br /> Parcel#(24 digits): 0:7- nZ r1 - 7 - 140 - 1'4 - ZO - S "OS . 009 -(:)11000 1 <br /> mss, � <br /> Tax ID#(1-5 digits): ' p,U J 0 Z <br /> N <br /> N <br /> Property Site Address#: Zq q g <br /> Road Name: C a k, L..Q kt I ocxcL City: WtS,- _4e r <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Reclb:Llm <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building s <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs 32 Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition t_-J,�) <br /> Proposed Structure/Addition Use: s p(5t <br /> :t> <br /> �� <br /> {( (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) +o. l� cq G <br /> Building Contractor: <br /> CR <br /> 0 <br /> Anticipated Start Date: c" �B <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 1/2016 <br /> b <br /> 2 <br /> m <br /> a <br /> m <br />