Laserfiche WebLink
LAND USE PERNUT APPLICATION— Burnett County. WI & 0 <br /> Permit Fees: 0 ti <br /> n. <br /> DwellingfPrincipal Building-Single Family $300 Addition to DwellingfPrincipal Building-Single Family $200 O <br /> w GQ <br /> DwellingfPrincipal Building-Multi-Famil $300 Addition to DwellingfPrincipal Building-Multi-Famil $200 <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 O <br /> Accessory Structure/Addition to Acc.Structure $150 Accessory Stricture or Bunkhouse $250 a <br /> Accessory Structure-Commercial(Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &Il) $200 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692(lv)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. v, <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, landsca in , retaining walls. <br /> ro <br /> 0 <br /> Applicant Complete All Sections Below This Line o �. <br /> N ' � �, <br /> Applicant's Name: ��+ y aY� �, Cch I/ <br /> Sm h _ <br /> Applicant's Mailing Address: /0-57,3r/ t0/`a S ,1 O <br /> T ej 1"(�s /,� <br /> Ci6 State Zip <br /> � z <br /> Applicant's Telephone Number: A 6 - - (1 C el b r -ii( 5 S- o <br /> p c <br /> Applicant's Email: �e0 h P C�4 VV r e0`Yt d <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. 1 <br /> ❑Letter ❑Phone Email N tl0 <br /> 0 <br /> Legal Description: OQ'-�' <br /> Lot#: Q CSM Vol. Pg. /0,6- OR G <br /> rn <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR t,( 1/4 A[/ 1/4 <br /> Section#:�_Town#: LO N Range#:__Z�__W Town of: �Ct c lit S D n 1 <br /> I y <br /> *Attach additional page if needeflfor lengthy description OR attach a copy of the deed OR attach tax system propertypage.* —� <br /> Parcel#(24 digits): e-0 Q G <br /> io n <br /> Tax ID#(1-5 digits): c7 z <br /> 7� <br /> Property Site Address#: <br /> Road Name:—Ly LQ 4' City: v <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:15Q-.CID <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition y <br /> 0 <br /> ❑ Stairs Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition <br /> C) C <br /> N <br /> Proposed Structure/Addition Use: is kyjIte y ]p <br /> (H a/Cabin;Commercial Business;Bedroom;Deck;etc.) 'm N Z z <br /> �� z � <br /> Building Contractor: se { oZ <br /> Z0 <br /> Anticipated Start Date: A S a 17® o <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 3/2015 <br /> x <br /> m <br /> A <br /> m <br />