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LAND USE PERMIT APPLICATION— Burnett County, WI a _ <br /> y. <br /> 70 <br /> Permit Fees: `; aIp <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 9 <br /> CommerciaUIndustrial Building $300 Addition to Commercial/Industrial Building $200 O <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 ( 7 <br /> ro <br /> Accessory Structure-Commercial CI &❑ $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692(lv)) $350 c i <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 S <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. n <br /> d <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. '— <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping, retaining walls. <br /> v <br /> Applicant <br /> Complete All Sections Below This Line S . <br /> Applicant's Name: ✓GFF(�AAL1Gly/L [ ° <br /> Applicant's Mailing Address:69ISya, ?epi$,/ n4, Sggq <br /> City State zip <br /> 71b�- 'fl(o 3�l/B 3 z <br /> Applicant's Telephone Number: n c y <br /> Applicant's Email: _ e-c{i A ry4d-t(J� Q rAa t , Com o <br /> d <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter ®Phone ❑Email b <br /> Legal Description: ar if• /o fo 7 lg I'Y5 37 T W Nti i Lt) 2. <br /> oc <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR r„ <br /> Gov't Lot#: OR 1/4 1/4 F <br /> Section#: Town#: N Range#: W Town of:sap_ff <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* H <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> y � v <br /> Property Site Ad s#: 0 ���� <br /> Road Name: 1 ► (1 City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building z <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> ❑ Stairs A Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure c <br /> ❑ Permit Extension LIGazebo—WI Stat 59.692(ly) L3Camping Unit ❑ Commercial Acc. Addition z <br /> h2ai<er Z <br /> Proposed Structure/Addition Use: C65%ovp y4 d >N Z C <br /> H elCabin;Commercial Business;Bedroom:Deck;etc.) �Z_T z <br /> _ <br /> Building Contractor: iN q -f/k,, (,t1A/1l �'JC,sse. l <Z <br /> ov <br /> CM <br /> Anticipated Start Date: Jb 'fu i is <br /> Page 10 4 0 � <br /> Burnett County,WI Land Use Application-Rev 4/2015 > ` J <br /> s <br /> S <br /> S <br /> m <br /> A <br /> m <br />