Laserfiche WebLink
LAND USE PERMIT APPLICATION -Burnett County, WI r <br /> a 3 <br /> N <br /> Permit Fees: $ C <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwell ing/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial(CI &11) $ Addition to Accessory Structure-Commercial Cl &11) $200 =` <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692(1 v)) $350 0 —C <br /> Camping Unit $100 Filling/Grading $150 <br /> r <br /> Permit Extension Valid for one year-Only I Allowed $100 � <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. <br /> d <br /> *Communication Towers&Signs require a different application form,see corresponding application and feu. <br /> *Items not listed above will be treated as accessory stntcatres,such as:pergolas,landscaping, retaining walls. 2 <br /> m <br /> Applicant Complete All Sections Below This Line a Q� <br /> z <br /> Applicant's Name: Mi ch o GLA"A t 2 1 n <br /> Applicant's Mailing Address:a9a u Sttatf, R4+ 35 WeiXtee WL 5gBC13 <br /> City State Zip rnr <br /> 3 <br /> Applicant's Telephone Number: rJ S(p(s Sal(* <br /> w <br /> G <br /> Applicant's Email:LL3Wj*e t' t tali ld-r ness Q tyt n-w t*C.o m 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 Ov ®Email tv <br /> a <br /> Legal Description: 5 e,e. a-#"fOLCIrW c. <br /> Lot#: CSM Vol. Pg. OR o <br /> N <br /> 'i <br /> Lot#: Block#: Subdivision Name: OR „ <br /> Gov't Lot#: OR _1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: 00X(0,rA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24digits):On-OW -CA-440-16033•y 03-CM-00W w <br /> a- <br /> ro <br /> n z <br /> Tax ID#(1-5 digits): t^��7q <br /> Property Site Address#: p{11 a <br /> "ems & <br /> Road Name:.sta 04 55 City: Wej <br /> TYPE OF PERMIT(S): Check appropriate box/boxes <br /> e MT <br /> Ll Single Rec� <br /> Single Family Dwelling Multi-Family Dwelling Filling/Grading Commercial Building x e <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition t-t�t v IGT J <br /> ❑ Stairs Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m <br /> N <br /> 11 Permit Extension L] Gazebo-WI Stat 59.692(ly) ❑ Camping Unit 13 Commercial Acc.Addition Z <br /> Proposed Structure/Addition Use: I'eahrap fe., aR CALISt1 ng 10"_ y <br /> (Home/Cabin;Commercial usiness;Bedroom;Deck:etc.) m v <br /> Building Contractor: SCAE 2 -1 ~-& �u <br /> 0 C91 t� <br /> Anticipated Start Date: aSaQ 9 <br /> O o <br /> Page 1 of 4 Z ETD <br /> Burnett County, WI Land Use Application-Rev 1/2016 ; 0 <br /> w <br />