Laserfiche WebLink
LAND USE PERMIT APPLICATION —Burnett Countv, WI <br /> N ^ <br /> N <br /> Permit Fees: <br /> a <br /> Dwelling/Principal Build' -Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 I[�p'ttipt <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Stmcture(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial Cl&Il $200 Addition to Accesso Structure Commercial C1&11 $200 <br /> Deck/StaimTatio/Retaining Wall/Sidewalk/Driveway& ° <br /> (Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692 iv $350 <br /> Camping Unit $100 Filling/Grading $150 ° <br /> Permit Extension(Valid for one year-Only 1 Allowed $100 Boathouse $500 ti <br /> a <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. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> o — <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: 1 M TL)-1 Gi:y i fl-T H <br /> t^ r , gg n <br /> Applicant's Mailing Address: 1 a' J ti ere,)e v.l �C Y ;VE 46,wicf2 S137 r b <br /> City State zip c <br /> Applicant's Telephone Number: 7U -977 - 779L-Applicant's Email: SC3C' hlt' �' It(I6'.V C''..V(1tkD(',C-tAry`% <br /> , I <br /> roSU <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> 0 <br /> ❑Letter []Phone Email <br /> Legal Description: Z $-> 77 Cc tz-it C Li:i Z M V IV P 33 <br /> Lot#: CSM Vol._ 0 Pg, 3 3 4, OR 5. <br /> Cn <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#:�OR 1/4 1/4 <br /> � I <br /> Section#: Town#: N Range#: W Town of: -i <br /> 1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properly page. <br /> Parcel#(24 digits): CJ 1 6 Z /J — Jra -S d -Dl,y —QI ZC e)y 1 <br /> 0 z <br /> Tax ID#(1-5 digs): <br /> S3 .32- <br /> Site Address:it , 7 7 � i2e j ci C <br /> PropertyZ- � � C�%t-'✓1 <br /> t <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: Le)-C.on <br /> ❑Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> r <br /> ❑Stairs A Acc. Structure(Non-bunkhouse) ❑ Commercial Acc.Structure <br /> ❑Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑Camping Unit ❑ Commercial Acc.Addition <br /> ❑ Boathouse ❑ Screen porch—campgrounds only ❑ Retaining Wail LlSidewalk/Driveway C <br /> Proposed Structure/Addition Use: C/R✓' i? S�v:r's �.. l Ot_.- N m o <br /> / orae/Cabin;Coniniereial Bu ness;Bedroon;Dec ) <br /> Building Contractor: J<e r1 Ct4el tt f e corf"AAaster Plumber: Z n u� <br /> 5 <br /> Anticipated Start Date: Z rn <br /> Page 1 of 4 U 11 1� <br /> Burnett County,WI Land Use Application—Rev 3/2016 <br />