Laserfiche WebLink
LAND USE PERMIT APPLICATION- Burnett County, WI <br /> w <br /> Permit Fees: ~ <br /> a <br /> Dwelling/Principal Building-Sin le Family $300 Addition to Dwelling/Principal Building-Sinle Family $200 ;\ U <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 v 1 <br /> Commercial/Industrial Building Addition to CommerciaVIndustrial Building $200 O <br /> Accessory Structure/Addition to Ace.Structure $150 Accesso Structure or Bunkhouse $250 <br /> Accessory Structure-Commercial(Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &11) $200 <br /> Deck/Stairs/Patios $125 1 Gazebo WI Stat 59.692(1 v)) $350 0 <br /> Camping Unit $100 Filling/Gradin $150 <' <br /> Permit Extension Valid for one year-Only1 Allowed) $100 0 - 1 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. 2. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. <br /> Applicant Complete All Sections Below This Line 0 . <br /> Z <br /> Applicant's Name: (n OR K t AC 47K ° <br /> Applicant's Mailing Address: Z13 C-19 EP45 ,gmon fi IUVt�S i�Stn1f155y6q <br /> City State Zip <br /> � z <br /> Applicant's Telephone Number: fp/a -ga7 _ 5a �6- °_ e <br /> Applicant's Email: m b4plt L ACEK 0 401 Com o <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> b <br /> Letter Phone ❑Email c °C t <br /> Legal Description: N ,off 1 op AU IN or S e=e+10 n 'bG7nSIj i P z/D A/L"FRAA6 S. <br /> as <br /> Lot#: CSM Vol. Pg. OR C I <br /> Lot#: Block#: Subdivision Name: OR a, t <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Qc2 Town#:-410 N Range#:-J(p W Town of: 014e L 40 ri 10 n 11 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): 0-7 - ®ac - /(o- Qa -1 D 1 - c96�?> <br /> x <br /> ° <br /> Tax ID#(1-5 digits): '� S 10 n z <br /> Property Site Address#:-412 4r y <br /> Road Name: C ou Dly: ©14 D (' City: p 40ty Bo RY <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec: j <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ,,,❑LLL Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition 5 <br /> ❑ Stairs Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure m �7t rl 1 <br /> L3 Permit Extension Gazebo-WI Stat 59.692(ly) ❑ Camping Unit L3 Commercial Acc.Addition z C <br /> n ZProposed Structure/Addition Use: RA <br /> (Nome/Cabin;Commercial Business;Bedroom;Deck:etc.) o 3 0 <br /> Building Contractor: vf-:- A0AZ_Qson 4�70r75-7` 0 N <br /> � Q o <br /> A. s Ar�1 <br /> Anticipated Start Date: m Z u <br /> Page 1 of 4 <br /> Burnett County, WI Land Use Application—Rev 3/2015 <br /> m <br /> a <br /> m <br />