Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI g =_ <br /> Permit Fees: � ?` <br /> Dwe ' c' al Buil -Single Family $300 Addition to Dwe ' ci Build' -S Family $200 <br /> Dwe ' c' al Buil -Multi-Famil 5300 Addition to Dwelling/Principal Building-Multi-Family 5200 _ <br /> ` Commercial4ndustrial Building $300 Addition to CommetcialMdustrial Budding $200 <br /> l► AccessoryStructure/Addition to Ace.Structure $150 Bunkhouse 5250 <br /> AccessoryStructure-Commercial(Cl&I l) 5200 Addition to A Structure-Commercial(C 1&II $200 <br /> Deck/Stairs/Patios $125 Gazebo Stat 59.692 lv $350 <br /> e <br /> Camping Unit $100 Fillip Gradin 5150 <br /> Permit Extension Valid for one year-Only 1 Allo $loo 5° n <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. y <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 /> Applicant Complete All Sectio s Below This Line S <br /> adE11 lS Cd/d1d z <br /> Applicant's Name: e <br /> / / /l n <br /> 7! 6 L' ,��1 <br /> Applicant's Mailing Address: i(,�D Map , r i`E'fk3 //� t �iJ (� <br /> City State zip to 9 <br /> /y6r" D <br /> Applicant's Telephone Number: ? �,f OGg d <br /> t7 <br /> / V.- c J <br /> Applicant's Email: eM! OV�mak i`10AA p <br /> j s <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ru <br /> [-]Letter Phone OEmail <br /> 0 <br /> Legal Description: ' c,) <br /> Lot CSM V01 j! OR T <br /> Lot#: Block#: Subdivision Name: OR a, w <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#:��Town#:_ N Range#:�W Town of: t/q G tr-fal <br /> 'Attach additional page if neededfor lengthy desenption OR attach a copy of the deed OR attach tax system property page.• 1 <br /> J <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): all 7?'�' ! �(f 3 jocr A <br /> Property Site Address#: 2?4; <br /> Road Name: Aed of City: b✓f7A �r �� J <br /> F <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: ��I-.�,, <br /> ❑Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑Commercial Building <br /> 0 Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition a <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑Commercial Acc.Structure N <br /> ❑ Permit Extension ❑ Gazebo—WI St/at 59.692(ly) ❑Camping Unit <br /> LJ Comrrterc iai Acc.Addition Z C <br /> Proposed Structure/Addition Use: __ �9�f# JFA BA -600" N,�'/jTl g L(�f;�ji17 Z <br /> (Home/Cabin;Commercwl Business;Bedroom;DeW etc.) TFT I- <br /> Building Contractor: A$ Z -� Ft ITO <br /> V� ' A <br /> (Do 2V *9 <br /> Anticipated Start Date: y C a-) <br /> Page 10 <br /> f 4 Z <br /> Burnett County, WI Land Use Application—Rev 1/2016 0 <br /> W <br /> M <br /> M <br />