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LAND USE PERMIT APPLICATION — Burnett County, WI § <br /> E. <br /> . Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) ° -tDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d vt. <br /> • Commercial/Industrial Structure Addition/Alteration to Commercial/Industrial Structure $200 ,...,.....a `� <br /> )( Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n _ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 of )ot1 <br /> Filling/Grading $150 Boathouse $500 r- A� <br /> 0 1" <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 — 1 <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. AD <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> rI <br /> Property Owner's Name: David Boldt ° z <br /> 0 <br /> Property Owner's Mailing Address: 1555 Briarknoll Circle Arden Hills MN 55112 0 <br /> City State Zip b0. <br /> Property Site Address:5901 Pike Lake Road c <br /> 3 <br /> Contact's Telephone Number: 651-253-2968 o <br /> . c <br /> Contact's Email: dboldt21@gmail.com a> a <br /> e <br /> a <br /> Legal Description of Property: ., <br /> Section#: 25 Town#: 39 N Range#: R16 w Town of: Meenon g cio <br /> B' <br /> "' <br /> *Attach additional page if needed for lengthy description OR attach a copy othe deed OR attach tax system property page.* <br /> P <br /> Tax ID#(1-5 digit number;found on tax statement): 11910 <br /> Proposed Use of Structure/Addition: Garage 1Z) <br /> Anticipated Start Date:July 19,2021 (Home/Cabin;Commercial Business:Bedroom:Deck:etc.) -3 -io <br /> Building Contractor: Northland Buildings&Olsen Concrete Sewer Installer: V <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 1 <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from theta prior to IQ) <br /> ANY construction taking place for any dwellings,dwelling additions.manufactured homes.manufactured z V <br /> home additions,and bunkhouses.** <br /> I meet 4 II 5e -64. 4,,v f l <br /> Nar 4f- ix torta4 44 <br /> Od <br /> s Fee Rec:A1 L-7) <br /> 7, Check#: c/115.° <br /> m <br /> Date of staff site visit: 7/i3) Initials of site visit staff: ALz <br /> . ' ..,c,-____JD <br /> ,, . i <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: i t— <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 4 c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 19 " `� <br /> c N <br /> CI g <br /> Transcendent: Page 1 of 4 '` i <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 a <br /> U <br /> J <br /> ti <br /> K <br />