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LAND USE PERMIT APPLICATION- Burnett County, WI <br /> s n b <br /> y H <br /> Permit Fees: g' vi <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 O <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 n <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 I 1 1 <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &11) $200 I �r <br /> Deck/Stairs/Patios $125 Gazebo WlStat 59.692(iv)) $350 <br /> Camping Unit ` <br /> $100 Filling/Grading Filling/GradingSI50 <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. ? ( n <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping, retaining walls. �J J <br /> 'v <br /> m <br /> Applicant Complete All Sections Below This Line S . <br /> Z <br /> Applicant's Name: ei Moo <br /> Applicant's Mailing Address: ar/Y'5,,; <br /> C,,; LOke W-4e-Fr--y�— - <br /> SY-7.3 <br /> City State zip <br /> $ -o r < <br /> Applicant's Telephone Numberk/u.'shA0 -(.�( �Ag�: f- 007-3 <br /> , 0 <br /> Applicant's Email: �D�/IcdW� <br /> —a v <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter Phone "Email c °` <br /> Legal Description: ' <br /> Lot#: CSM Vol. Pg. OR o <br /> N <br /> n <br /> Lot#: Block#: Subdivision Name: OR „ so <br /> Gov't Lot#: OR 1/4 1/4 o <br /> I � 1 <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional a e i needed or lengthy description OR attach a co o the deed OR attach tax system ro er a e. <br /> P8 f .f 8 Y P PY f Y P P tYPB <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): r z <br /> � a <br /> Property Site Address#: <br /> Road Name: City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:kSOp <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition 1 Deck/Patio ❑ Commercial Addition 5 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> ❑ Permit E=xtension ❑ Gazebo–WI Stat 59.692(ly) ❑ Camping Unit �❑�nCommercial Acc. Addition72C ^J <br /> Proposed Structure/Addition Use: 1167r`-C. y yam/, �G , Z "����� <br /> �` <br /> Home/Cabin;Commer ( usiness;Bedroom;Deck;etc.) m� 'o <br /> Building Contractor: 0 V �] <br /> O <br /> Anticipated Start Date: m C La <br /> Page 1of4 0 -7� <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> m <br /> A <br /> m <br />