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LAND USE PERMIT APPLICATION-Burnett County WI g b <br /> Permit Fees: ^o <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Egg $200 G <br /> Dwelling/Principal Building-Multi-Famil $300 Addition to Dwelling/Principal Building-Multi-Family $200 0 <br /> Commercial/Industrial Building $300 Addition to CommerciaVlndustial Budding $200 1 0 <br /> Accessory Structure/Addition to Ace.Structure150 Bunkhouse 5250 l O <br /> Accessory Structure-Commercial C 1&[1 $200 Addition to Accessory Structure-Commercial C 1&H) $200 f°t <br /> Deck/Stairs/Patios $125 Gazebo Stat 59.692(l y 5350 / <br /> 0 <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension(Valid for one year-Only 1 Allowed $100 or <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. Ln <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:pergolos.landsc ing,retainingwalls. 7 <br /> rn <br /> Applicant Complete All Sections Below This Line ; . <br /> Applicant's Name: ` Q'-, ,I � (� <br /> Applicant's Mailing Address: y� 3b NAAM LAKE R0 & <br /> DAN )RY LOT_ �Y8 �1 <br /> City State Zip <br /> / / p � <br /> Applicant's Telephone Number: 1\5- RV4_ Cj 5OO o <br /> a <br /> Applicant's Email: <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> b <br /> QLetter XPhone ❑Email c I <br /> r_ <br /> Legal Description: ,p �'�C�'1 e g- <br /> C <br /> Lot#: CSM Vol. Pg. OR �. y <br /> 3. <br /> Lot#: Block#: Subdivision Name: OR r„ <br /> Gov't Lot#: OR 1/4 1/4 I 1 0 <br /> I�1 <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 attach tax svetem property page.* I <br /> I <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): n yz. <br /> &INC—F <br /> Property Site Address#: <br /> Road Name: to A M City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:/ .�1 <br /> Ll Single Family Dwelling 13 Multi-Family Dwelling LJFilling/Grading ❑ Commercial Building e 1 — <br /> ❑Single Family Addition ❑ Multi-Family AdditionN'tE5 <br /> Deck/Patio LJCommercial Addition -7 ! o <br /> ❑Stairs Am-Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure I <br /> Ll Permit Extension 13 Gazebo-WI Stat 59.692(ly) Ll Camping Unit Ll Commercial Acc. Addition 7 <br /> , ( , c, 0 <br /> Proposed Structure/Addition Use: ,Au) �A�bE1J 5lCgi F - �� X Imo{ C <br /> 1 11 (Ho e/Cabin;Commercial Business;Bedroom;Deck etc) Z <br /> Building Contractor: Ln C r1C Q �(A l Lpl�Y� — QzL N 1f� Dc-c V, { 0 m <br /> 33 3 sr3 r. z <br /> Anticipated Start Date: �e1 N�k�T n Z 0 <br /> N <br /> Page 1 of 4 0 Z <br /> Burnett County,WI Land Use Application—Rev 1/2016 <br /> C' m � <br />