Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI C4 <br /> z , <br /> Permit Fees: <br /> Dwellin rinci al Building-Single Family $300 Addition to DwellinglPrincipal Building-Single Family E <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family K <br /> Commercial/Industrial Building $300 Addition to CommerciaVIndustrial Building O <br /> AccessoryStructure/Addition to Acc.Structure $150 Bunkhouse Accesso Structure-Commercial Cl &Il $200 Addition to Accesso Structure-Commercial CI &Il) <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.6920v)) $350 0 <br /> Camping Unit $100 Filling/Grading $150 <br /> r <br /> Permit Extension Valid for one year-Only 1 Allowed $100 ° <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:pergolas,landscaping, retaining walls. <br /> 'o <br /> Applicant Complete All Sections Below This Line c . <br /> 1�oNNA PR�Dg z <br /> Applicant's Name: CAfu <br /> %'� ) <br /> Applicant's Mailing Address: I r�Cl�1 1 !�01K*5 4A) E,4 (,A A) MA) 5-51 <br /> t Jd- <br /> City State <br /> Zip W <br /> Applicant's ant's Telephone Number: 01- 1Sb" 957 (* �) bz <br /> o y �` <br /> c <br /> c <br /> Applicant's Email: �� �I��CED Gt1'1Q r� • �C 1'1'1 ^p <br /> d <br /> If staff has a question about this application how do�you prefer to be c cted? Check one below. <br /> ❑Letter Ri hone mail N oc t <br /> 1 5 <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR o <br /> w <br /> a. <br /> Lot#: Block#: Subdivision Name: OR a <br /> Gov't Lot#: OR 1/4 1/4 <br /> 70 <br /> Section#: Town#: N Range#: W Town of: 1 0 <br /> *Attach additionalpage if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertyPaBe.* y <br /> � I <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): y <br /> Property Site Addr ss#: ti <br /> Road Name: ou.I I La DrCity: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: Ian.oO <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> H <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition 4 <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure8 CD <br /> m <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc.Addition C <br /> n � <br /> Proposed Structure/Addition Use: 'PI A i P r1i/5 £ 1'61 i��b y (ls�s(P 0 e i S�t n u ^� <br /> (H meICab' ;Co mer a Bus Hess; droom;Deck;etc.) d dJ <br /> c"FP�nncl• d',��'k�` �aA ac e-5 . <br /> Building Contractor: 405 r A kit Crr-r?.x h Aw!x 14- Ard i e r O <br /> Anticipated Start Date: l - « Z <br /> Page 1 of 4 0 <br /> Burnett County,WI Land Use Application—Rev 1/2016 a <br /> b <br /> S <br /> m <br /> m <br />