Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI ro <br /> a <br /> N y <br /> Permit Fees: o r <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 I�( <br /> CommercialAndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial Cl &I1) $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> 1 <br /> "W/Stairs/Patios Gazebo(WI Stat 59.692 Iv) $350 0 <br /> Camping Unit 0 Filling/Grading $150 <br /> Permit Extension Valid for one yeLr-_Only 1 Allowed) 1 $100 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 accessorystructures,such as:pergolas, landscaping,retainingwalls. Q <br /> 'o <br /> m <br /> Applicant Complete All Sections Below This Line . <br /> z <br /> 0 <br /> Applicant's Name: 40"4 ,n/ /�L 00 � <br /> Applicant's Mailing Address:_ ;Z3 7Cj � L{G`iy^ / P,/ A�>-3a-4pl <br /> City State zip �n <br /> IKX-275--Applicant's Telephone Number: <br /> Applicant's Email: /;71;ee 3�14Cct­r - CAD- t-jp,(� , Cow-i o <br /> M <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. 1 <br /> ❑Letter hone ❑EmailN <br /> Legal Description: �. vvVlll <br /> w <br /> Lot#: CSM Vol. Pg. OR o j <br /> Lot#: Block#: Subdivision Name: OR r„ <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: I ° LN, <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage.* � <br /> Parcel#(24 digits): W <br /> Tax ID#(1-5 digits): z <br /> a <br /> Property Site Address#: 11S02 y <br /> Road Name:--,54%LXL � City: !�LeC 1 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes '' <br /> Fee Rec: • 00 <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> 0 <br /> irs` ❑ Acc. Structure(Non bunkhouse) ❑ Bunkhouse E3 Commercial Acc. Structure o <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑Commercial Acc. Addition <br /> a y Z mU <br /> Proposed Structure/Addition Use: J�r�l rs m cu <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) X) r <br /> et 4: <br /> Building Contractor: 9/� n r.A rr.: <br /> 4) O Q "~�.•...A <br /> Anticipated Start Date: m <br /> Page 1 of 4 0 <br /> Burnett County,WI Land Use Application—Rev 4/2015 <br /> x <br /> m <br /> m <br />