Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI g _ b <br /> H y � <br /> Permit Fees: g <br /> Dwell in /Princi al Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 d <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 C� <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) [� <br /> Addition to Ace.Structure $150 Bunkhouse $250 1 t <br /> Accessory Structure-Commercial C I &H) $200 Addition to Accessory Structure-Commercial C 1&I l $200 � (`JIII <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> (Screen orches-in campgrounds only) $125 Gazebo(W[Stat 59.692(ly)) $350 <br /> Camping Unit $100 Filling/Grading $150 S <br /> Permit Extension(Valid for one yat-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. r <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. _� 1 <br /> *hems not listed above will he treated as accessory structures,such as:pergolas, landscaping,etc. r <br /> o - <br /> Applcant Complete All Sections Below This'Lime <br /> I <br /> Applicant's Name: ,�,..y 01 ;T o-;.x <br /> Applicant's Mailing Address: '6 Y La 5 <br /> � u <br /> City State Zip <br /> c d <br /> Applicant's Telephone Number: a <br /> O 6 <br /> m <br /> Applicant's Email: <br /> i <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> a <br /> ❑Letter ®Phone ❑Email�'J <br /> Legal Description: _rr rz�14t%j w. fi, -Ya. ��� +�/L' -m, �`x"t`'X t o <br /> Lot#: z/���C�M Vol. Pg. OR <br /> / <br /> Lot#: Block#: Subdivision Name: R° � 4.�"' �- OR <br /> Gov't Lot#: OR 1/4 1/4 , <br /> I <br /> Section#:_� Town#:_YC -N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> r <br /> Parcel#(24 digits): <br /> � z <br /> Tax ID#(1-5 digits): 02 May <br /> " 7/2,5 <br /> Property Site Address: &Ony L�� �.x� _ �' S,PPl <br /> TYPE OF PERMIT(S): Check appropriate box/boxes <br /> Fee Re :�l <br /> ❑ Single Family Dwelling Cl Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building Ct <br /> LJ Single Family Addition Ll Multi-Family Addition A-Deck/Patio ❑ Commercial Addition l <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ty) ❑Camping Unit ❑ Commercial Acc. Addition <br /> ❑ Boathouse ❑ Screen porch-campgrounds only ❑ Retaining Wall <br /> ❑ Sidewalk/Driveway C Q <br /> Proposed Structure/Addition Use: �,n�cl�J.+ctiT �� (1,7 ' ,L�+ �hi�+e� �� NZ n <br /> Kdm!!L:'ai r' in c 1, urine o :Deck:etc) O <br /> Building Contractor: (fl 4c�tc1, Master Plumber: Z 0 e� f'If <br /> Anticipated Start Date: L� L/�i rw �} .- -T+r�z _o C==Page 1 of 4 Z Cn <br /> Burnett County, WI Land Use Application—Rev 3/2016 <br />