Laserfiche WebLink
LAINI UNE rbRIV111 AYYLIt-A 1 1"lN - lsurnett t-ount W 1 f g r <br /> ON COW R/S EIZ <br /> Permit Fees: eT <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellinglPrincipal Building-Single Family $200 3a <br /> Dwelling/Principal Budding-Multi-F $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> CommerciaUlndustrial Build' $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure(Non-Bunkhouse) <br /> Addition to Acc.Structure $150 Bunkhouse $250 1 <br /> Accessory Structure Commercial C 1 8t Il $200 Addition to Accessory Structure Commercial Cl&Il $200 _ <br /> Deck/Stairs/Patio/Retaining Wall/SidewaWDnveway& <br /> Screen orches-in campgrounds only $125 Gazebo Stat 59.692 lv $3511 r <br /> Camping Unit $100 Filling/Grading Filling/Grading $150 ° <br /> Permit Extension(Valid for one year-Only 1 Allowed $100 Boathouse $500 t I r� <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. b <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping, etc. fD <br /> 1bpl Complete All Sections Below This Line I S z <br /> Applicant's Name: D-i�+el •,05)w- Q.w�i- 1,w4ht-H+ <br /> Applicant's Mailing Address: /3&3_7 moi^s CT /4�PtF_ I�`��u y " _fSi z`7 1 <br /> City State Zip < ,c <br /> Applicant's Telephone Number: 4S 2 ?L 3 SG S o <br /> a <br /> Applicant's Email: �.►Nvyt! w�rriv d�,,,:i�• ��i..t <br /> I <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> w <br /> Letter Phone ®Email 9- <br /> Legal Description: Lo 31 P. v.R. P . Z 1/r v 00 <br /> Lot#: CSM Vol. Pg. OR 5. y <br /> Lot#: Block#: Subdivision Name: OR I( � <br /> Gov't Lot#: OR 1/4 1/4 1 {" <br /> Section#: Town#: N Range#: W Town of: y <br /> *Attach additional page ifneeded for lengthy description OR attach a copy of the deed OR attach tax system property page.* L <br /> Parcel#(24 digits): ` 03Z "Z`• W44 4 'Y-D 3 - oco - O1 9 oeo <br /> n z <br /> Tax ID#(1-5 digits): 7° <br /> Property Site Address: <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee RecAMI-M <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> Single Family Addition ❑ Multi-Family Addition ;9 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 ElRetaining Wall LJSidewalk/Driveway <br /> Proposed Structure/Addition Use:Ar.- ++, SAL A.I.std -A 1RW1L ,'04254,. M <br /> C:) <br /> t� <br /> (Home/ abin;Commercial Businesk Bedroom;Weck;e t.) Z > <br /> Building Contractor: P� Q'Io-PS &_X,1I�b> Twp MasterPlumber:roxuv �..06,41Pvv�Ob7Y2o N � <br /> Anticipated Start Date: W14.1 ;2 tD 1 ''7 <br /> Page 1 of 4 � iT <br /> Burnett County,WI Land Use Application-Rev 3/2016 <br />