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LAND USE PERMIT APPLICATION — Burnett County, WI F <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) G <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $2002 ,--k is ti <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 pp__ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' ) r <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° ,,, <br /> F <br /> Filling/Grading $150 Boathouse $500 wl <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 /_ 11 <br /> D <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. � <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. :5 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. e.; <br /> le <br /> Property Owner's Name: Mark and Pam ROSenow o IP <br /> Property Owner's Mailing Address: PO Box 488 Spooner WI 54801 c <br /> City State Zip O <br /> Property Site Address: 1175 Popple Road a (r <br /> t <br /> Contact's Telephone Number:612-799-4156 0 <br /> rD <br /> G <br /> m rosenow gmail.com oContact's Email: <br /> E <br /> Legal Description of Property: NW NE of Sec 36 T 39 N R 14 W 1J <br /> Section#:36 Town#:39 N Range#: 14 W Town of: Rusk <br /> e <br /> F <br /> ac <br /> *Attach additional page if needed for lengthy description OR attach a copyofthe deed OR attach tax system property age.* <br /> q <br /> 71. <br /> Tax ID#(1-5 digit number;found on tax statement):40773 <br /> ..'...4—:) <br /> Proposed Use of Structure/Addition: Permanent Residence s <br /> Anticipated Start Date:May-June 2022 (Home Cabin;Commercial Business:Bedroom;Deck:etc.) c Y <br /> Burch Construction/VVausau Homes Dan Burch d <br /> Building Contractor: Sewer Installer: <br /> a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o, <br /> **The applicant needs to contact their UDC'Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** <br /> 0{}lee\- 41< Beebe.c <br /> 00,Aielli vlo -O E<Ceecl 3 brooms .Qe.r 541\i- 2g-aS <br /> Mtn 6 <br /> Fee Rec: <br /> Check#: "Mg_ <br /> Date of staff site visit: 2/ 151 -^U� (1-1L y <br /> Initials of 'te visi sta � z <br /> d <br /> APPROVED BY LAND SERVICES OFFICIAL: Al ' /ter. DATE: ,2//7/2-i - < <br /> UPON APPROVAL: APPLICANT UST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> 7.1 CO <br /> Transcendent: Page 1 of 4 . g <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 w * l <br /> a- <br /> N <br />