Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI UP 15' <br /> caner ' <br /> Permit Fees: <br /> $30 IN# 11 l <br /> DwellirwPrincipal Building-Sinfrie Family 0 Addition to DwellinglWincipal Building-Single Family 5200 <br /> S30 <br /> Dwelling/Principal Building-Multi-Family 0 Addition to DwellmWPrincipal Building-Mufti-Family $200 (� <br /> S30 <br /> Commercial/Industrial Building 0 Addition to Commercial/Industrial Building 5200 1crinit Issued <br /> $15 Date) <br /> Accessory Structure/Addition to Acc.Structure 0 Bunkhouse 5250 Sanitary Permit <br /> S20 o. Issued <br /> Accessory Structure-Commercial Cl&Il Addition to Accessary Structure-Commercial(Cl&11) 5200 Date) <br /> S12 <br /> Deck/Stairs/Patios Gazebo w'I Stat 59.692 lv - 5350 Town <br /> s10 <br /> Cam in Unit 0 FillinjF)CYrading S, <br /> s10 %.Gov't <br /> Permit Extension Valid for one vear-Only 1 Allowed 0 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. t <br /> *Communication Towers&Signs require a di„�erent application form, see corresponding application and fees i�ot C5M <br /> *items not listed above will be treated as access structures,such as:pergolas, landsc ,in retainingmalls. <br /> i£ S tl <br /> Applicant Complete All Sections Below This Line T N <br /> 2 - � 1 . W <br /> Applicant's Name: M2 'dD {' per' 4 <br /> — ubdiyision <br /> Applicant's Mailing Address: $ +l 4 <br /> City State Zip zoning <br /> istrict <br /> Applicant's Telephone Number:_ ' 3284 - 1"143 Lake Class <br /> Applicant's Email: m�re�ear i cjCs 2r7 .._ 4t ro ju j-Lo m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. FOR OFFICE <br /> ❑Letter ❑Phone Email SE <br /> Legal Description: 2,ai is bo!W LAkL U4 7.4 <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR I/4 1/4 C <br /> Section#:Z_Town#: rLjb_N Range#:$ { (—, W Town of:kaki 12,nA z C <br /> *Attach additional page if needed for lengthy description OR anach a copy of the deed OR attach tax system property page.* Z r <br /> Parcel#(24 digits): Qri - 02.0- 2 - A40-1&- 1 G-5- 15- G5( - b3"f000 Z0 N <br /> ca <br /> Tax ID#(1-5 digits): 14917 C <br /> TH <br /> Property Site Address#: Q((0_ - issl <br /> (� <br /> Road Name: J&± e-C Gb I d 1�,4 City: -1{-,sin In tA-r-q zo <br /> NE <br /> TYPE OF PERMIT(S): Check appropriate boxiboxes N <br /> Single Family Sc'r Fee Rec: <br /> y Dwelling F ng/Grading 13 Commercial Building T <br /> DwellingAF <br /> ❑ Single Family Addition ❑ Multi-Family Addition 0 Deck/Patio ❑ Commercial Addition o ISO <br /> 'p�9leira— Cl Acc.Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Ace. NL <br /> Structure <br /> ❑ Permit Extension 13 Gazebo—WI Stat 59.692(l v) ❑ Camping Unit ❑ Commercial Ace.Addition ca <br /> Iv <br /> Page 1 of 4 EST <br /> Burnett County, WI Land Use Application—Rev 4/2015 nt <br /> P <br /> HE <br /> RE <br />