Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI a 0 ro <br /> H ~ <br /> Permit Fees: g ?� <br /> a <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 O <br /> DwellingfPrincipal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 m <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 O <br /> Accessory Structure(Non-Bunkhouse) ' o <br /> Addition to Acc.Structure $150 Bunkhouse $250 <br /> Accessory Structure-Commercial Cl &Il $200 1 Addition to Accessory Structure-Commercial(Cl & I I 1 $200 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(lv)) $350 r <br /> Camping Unit $100 Filling/Grading $150 °^ <br /> Permit Extension Valid for one year-Only l Allowed $100 Boathouse $500 <br /> w <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 /> *ltems not listed above will be treated as accessory structures,such as:pergolas,landscaping, etc. <br /> s <br /> Applicant Complete All Sections Below This Line o <br /> Applicant's Name: <br /> S s"S Lot /3rz?ke �r� 'Eal« IVA SYS <br /> Applicant's Mailing Address: z <br /> / City State zip <br /> Applicant's Telephone Number: ( 572–— Z2_1 -07/� o <br /> q n t <br /> d <br /> Applicant's Email: mt4YST/ I"- ggAa i Cd11'I <br /> I <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N b l <br /> ❑Letter ❑Phone mail ] <br /> a <br /> Legal Description: o <br /> H <br /> Lot#: CSM Vol. Pg. OR 1 <br /> Lot#: Block#: Subdivision Name: OR o <br /> F <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: <br /> *A ttach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): <br /> � z <br /> Tax ID#(1-5 digits): <br /> Property Site Address: 27'f60 <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: I S� <br /> ElSingle Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs �1 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 ❑ Sidewalk/Driveway m <br /> Cai <br /> 3 <br /> Proposed Structure/Addition Use: a ram C N <br /> Wo a/Cabin;Commercial Business;Bedroom;Deck;etc.) Z m <br /> N <br /> Building Contractor: 154vt RoSSo� Master Plumber: Z C) �' o <br /> Anticipated Start Date: (.I te, O•C TA � (.0 Z rn <br /> Page 1 of 4 < M <br /> Burnett County,WI Land Use Application—Rev 3/2016 <br />