Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI _ b <br /> a <br /> < <br /> Permit Fees: <br /> Ir 710 <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sin le Family $200 O <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 9 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Ace.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial C1&Il $200 Addition to Accessory Structure-Commercial(Cl&II) $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> (Screenporches-in campgrounds only) $125 Gazebo(WI Stat 59.692(lv)) $350 <br /> r <br /> Camping Unit $100 Filfing/Grading Filling/Grading5150 °^ <br /> Permit Extension Valid for one year-Only I 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. <br /> PW <br /> *Items not listed above will be treated as accessoty structures,such as:pergolas, landscaping,etc. <br /> r <br /> o — <br /> Applicant Complete All Sections Below This Line <br /> Applicant's Name: L o t-e k) &644- <br /> Applicant's <br /> 644- <br /> Applicant's Mailing Address: ,de g7a,v ree os $T,Qit.0 srt c> 5�i❑7 �p <br /> City State Zip <br /> o <br /> Applicant's Telephone Number: (e`j/- oZ 9S�/i tf p/ •t wpp n`^�5 a <br /> Applicant's Email: !OTlt flu T <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N t <br /> ❑Letter [hone EjEmail <br /> Legal Description: PGL- Go tt t_o-'f I LL. I�" ��9�' o Ul t <br /> Lot#:_ 9 CSM Vol. Pg. OR K' } <br /> Lot#: Block#: Subdivision Name: OR _ 3 <br /> Govt Lot#: t OR 1/4 1/4 <br /> Section#: to Town#: N Range#:___[4__W Town of: t <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 1 <br /> r <br /> Parcel#(24 digits): ao( - es Ij;9 60 � <br /> � z I <br /> Tax ID#(1-5 digits): <br /> Property Site Address: Lq4 nn d �e,r .w Sok d <br /> a <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: ( <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs Acc. Structure (Non-bunkhouse) ❑ 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 Wall )l Sidewalk/Drivewa <br /> Proposed Structure/Addition Use: Gam 1 q e �+J v' <br /> m <br /> (Home/Cabin;Commercial Business;Bedroom;Deck etc.) Io� � <br /> Building Contractor: Q.4 `D Master Plumber: \ Z <br /> Anticipated Start Date: 1&�t 0-N ;�L o ( LD 17 O Nocgl <br /> CF <br /> Page 1 of 4 Z �Ul <br /> Burnett County,WI Land Use Application—Rev 3/2016 �� <br />