Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> E'' w <br /> Permit Fees: ' <br /> Dwellin rinci al Building-Single Family <br /> $300 Addition to DwellinglPrincipal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwellin rinci al Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 v1N o <br /> AccessoryStructure/Addition to Acc.Structure $150 Bunkhouse $250 I ry l E <br /> Accessory Structure-Commercial Cl &Il $200 Addition to Accessory Structure-Commercial Cl &I1) $200 x/ ^-{- <br /> Deck/Stairs/Patios $125 Gazebo WI Stat 59.692(lv)) $350 c V <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only I Allowed) $100 <br /> 0 <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. <br /> *Items not listed above will be treated as accessory structures,such as: ergolas, landscaping, retaining walls. P2 <br /> ro <br /> m <br /> Applicant Complete All Sections Below This Line ? <br /> Applicant's Name: ClG, ICOeP <br /> asass �l� 3 s a <br /> Applicant's Mailing Address: ll/Ptlsk� lel 53�SQ3 <br /> � City State zip b <br /> Applicant's Telephone Number: 716-'��6' VS7( o y <br /> Applicant's Email• �ltAtkotome �in54. eo n <br /> —r w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. I <br /> ❑Letter ❑Phone ®Email <br /> 0 <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR G r -C <br /> 5. <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 0 <br /> Section#: Town#: N Range#: W Town of: /feCNort t <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): J? "�g 1 -39-/C —/q-�U �r9oU /�O� <br /> Tax ID#(1-5 digits): �16I z <br /> Property Site Address#: <br /> Road Name: 0/J 35- City: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building s <br /> .VrSingle Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition z �--� <br /> n M <br /> Proposed Structure/Addition Use: 9,AC(1,M" loyr,,C*c e Z n <br /> (Home/Cabin;Oommercial Business;Bedroom;Deck;etc.) t� 1 <br /> Building Contractor: Ly yn� lfl /f/�/uff IJ u u <br /> N <br /> Q <br /> Anticipated Start Date: b�/3 20101 n �' z <br /> Page 1 of 4 0 <br /> Burnett County,WI Land Use Application—Rev 1/2016 <br /> 9 <br /> S <br /> (1p] <br /> A <br />