Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County. WI a b <br /> Permit Fees: ; a <br /> A <br /> Dwellin rinci al Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 C7 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/industrial Building $300 Addition to CommercialAndustrial Building $200 v O <br /> Accessory Structure(Non-Bunkhouse) \ E <br /> Addition to Acc.Structure $150 Bunkhouse $250 \ <br /> Accessory Structure-Commercial C1&I1 $200 Addition to Accessory Structure-Commercial Cl &I I I $200 C) l \ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway& <br /> Screen orches-in campgrounds only) $125 Gazebo WI Stat 59.692(lv) $350 S <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 Boathouse $500 <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. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,etc. <br /> �-� Applicant Complete All Sections Below This Line o <br /> Applicant's Name: ►►Y7)C ` h [J Q (i�L� ✓ <br /> Applicant's Mailing Address: p t{ Z s S)< l'\ Sr �l'l �}j J J iA;�1 Z r y U S,516OV 2 r b <br /> A City State Zip z <br /> Applicant's Telephone Number: Ln S� Y30 -10 <br /> uS a I <br /> Applicant's Email: -7 .S,6Q('jCer @_ C 0 Ox e a_l �-- n t <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. N <br /> 0 <br /> r ❑Lettepr Phone []EmailI <br /> Legal Description: S71 is —T3O N - t�/yW 4 <br /> w <br /> Lot#: r CSM Vol. Q 5 Pg. �_5 OR a <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: IO OR 1/4 1/4 1 <br /> Section#: Town#: 3 S AJ N Range#:__Z�1_W Town of: CIU T <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): 6 72- 3 / �✓`� `U S 6 C�O u b )y D b 0 I <br /> r, z <br /> Tax ID#(1-5 digits): 3(3 ) / <br /> Property Site Address: 30V l7 t3Aj-lhas l aI6 AQot �j1) ZA/w <br /> s <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec jz:,,� <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ 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 ❑ Retaining Wall ❑ Sidewalk/Driveway C <br /> Proposed Structure/Addition Use: NZ o <br /> (Home/Cabin;Commercial Business;Bedroom;Deck.,etc.) Q c <br /> Building Contractor: Master Plumber: Z <br /> Anticipated Start Date: ')CO Qom— <br /> Page 1 of 4 z <br /> Burnett County, WI Land Use Application -Rev 3/2016 <br />