Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett Countv. WI r <br /> Permit Fees: _ n <br /> D%vellin 'Princi al Building-Sinek Famil% $3110 Addition to U%%ellin .1'rinci al Buildin -Single I amih >2un j 1 <br /> Dwellin /Princi al Building-Multi-Family 5300 .Addition to D%%ellms'Principal Building-Mull14annih s'um I <br /> Commercial/Industrial Building 5300 Addition to Commercial Industrial Building S20m <br /> Accesson StructureAddition to Acc.Structure 5140 Bunkhouse 5250 <br /> Accesson structure Commercial C I&I I 1 52011 .Addition to Accesson Structure-Commercial C I&I I 5200 <br /> Deck/Stair,['arms 5125 Gazebo WI Stat 59.69211%71 5350 <br /> Camping Unit 5100 Filling/Grading $150 _ <br /> Permit Extension Valid for one Near-Onk I Allo%cdt $100 = <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three time%the normal fee. r <br /> *Communication Towers&Signs require a different application form,see corresponding application and)ees. <br /> •h.ms pint licr.d cthore will he treated ac accrssan >tr•ucfures.such as: ter'olas,landscaping.retaining walls. <br /> Applicant Complete All Sections Below This Line <br /> z <br /> Applicant's dame: 04Z �JIA14,4 L4A/A4&,J - <br /> Applicant's Mailing Address: f(�v{x Cr -Tfi <br /> G <br /> Citl State Zip <br /> Applicant's t's TelePhone Number: 4241-J01-01 <br /> G <br /> Applicant's Email: % AI_u9.1)ftLik QMQI . (yoic N <br /> '—_ PY <br /> 00 <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. j <br /> t r�' <br /> []Letter Phone ❑Email IpQ <br /> Legal Description: askil(fyp 1�1T ( Lac tnldlaZSK'{'�3/ TSU Q1 m _ �—I• y <br /> Lot#: CSM Vof Ntl(e Pg./,31 OR <br /> Lot#: Block#: Subdivision Name: OR r^ <br /> Gov't Lot#:A OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional page if neededfor lengthv description OR attach a copy of the deed OR attach tax system properh page.• V 1 <br /> r ' <br /> Parcel#(24 digits): 07-C679 P5LWa-fj/3000 <br /> ( g ) 1874 Coo�� z <br /> Tax ID# I-5 digits <br /> Property Site Address#:c:,2 ryIl{oD N)LARD R"M 6WD) <br /> Road Name:ALL QAD City: Wim- 549D <br /> E <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: � <br /> Single Family Dwelling J Multi-Family Dwelling J Filling/Grading ❑Commercial Building <br /> .1 Single Family Addition ❑ Multi-Family Addition J Deck/Patio ❑Commercial Addition = _430&— buythl <br /> ❑Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(ly) J Camping Unit ❑ Commercial Acc. Addition z <br /> I c r <br /> Proposed Structure/Addition Use: Pomf_ (���l� <br /> (Honie Cabin:Commernal Business:BeAroom:Deck:etc.) <br /> Building Contractor. M)KE &A.50J <br /> Anticipated Start Date:_ <br /> Page 1 of 4 <br /> Burnett County, WI Land Use Application - Rev 4/2015 <br /> s <br /> A <br /> T. <br />