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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> Permit Fees: <br /> DwellingfPrincipal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 a <br /> d <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwellin ci al Building-Multi-Family $200 g <br /> Commercial/Industrial Building $300 Addition to CommereiaUindustrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse1 <br /> $250 <br /> Accessory Structure-Commercial Cl&I1 $200 1 Addition to Accesso Structure-Commercial Cl&11) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screenporches-in campgrounds only) $125 Gazebo WI Stat 59.692 Iv $350 O <br /> Camping Unit $100 Filling/Grading $150 °^r <br /> Permit Extension Valid for one year-Only 1 Allowed $100 Boathouse $500 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. 4-4 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping, etc. <br /> Applicant Complete All Sections Below This Line o <br /> in <br /> Applicant's Name: Leroy and Judith Olheiser 00 <br /> J <br /> Applicant's Mailing Address: PO Box 703 Wyoming, MN 55092 <br /> City_ State Zip2. <br /> C <br /> Applicant's Telephone Number: 651-260-9448 `$ <br /> d <br /> Applicant's Email: j.olheiser@frontiernet.net <br /> I <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N °q <br /> ❑Letter ®Phone ❑Email <br /> UQ 1 <br /> Legal Description: SW NW Sec 31 T 38 R 15 r7 <br /> s. <br /> Lot#: CSM Vol. Pg. OR r 1 <br /> Lot#: Block#: Subdivision Name: OR y <br /> Gov't Lot#: 4 OR SW 1/4 NW 1/4 1 1 <br /> Section#: 31 Town#: 38 N Range#:__t5__W Town of: LaF011ette y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): 07-014-2-38-15-31-5-05-004-01.1000 <br /> Tax ID#(1-5 digits): 10094 <br /> Property Site Address: 22712 Paulich Road <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Ren� 5 O <br /> ,NfSingle Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building ' <br /> ❑ Single Family Addition ❑ Multi-Family Addition C Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ,7( Acc. Structure (Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(iv) ❑ Camping Unit ❑ Commercial Acc.Addition ay <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wall ❑ Sidewalk/Driveway C <br /> Proposed Structure/Addition Use: Home N M <br /> (Home/Cabin;Commercial Business;Bedroom:Deck:etc.) O r <br /> Building contractor: Burch Enterprises LLC Master Plumber: Burch Plumbing 'Z O o <br /> Anticipated Start Date: July 21, 2016 Z Q <br /> Page 1 4 r J <br /> Burnett County, WI Land Use Application—Rev 3/200 16 <br />