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LAND USE PERMIT APPLICATION — Burnett County, WI = b <br /> Applicant Complete All Sections Below This Line =N <br /> CD I <br /> 0. <br /> Permit Types and Fees:(Please,check appropriate boxes) v <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 --t-,p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <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 .2 ) <br /> Filling/Grading $150 Boathouse $500 cA <br /> w <br /> Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r 0. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. p <br /> T1 <br /> Property Owner's Name:John Childs a <br /> E. <br /> Property Owner's Mailing Address: Po Box 149 Webster WI 54893 E <br /> City State Zip c <br /> Property Site Address:TBD <br /> a <br /> Contact's Telephone Number:715-259-3257 0 <br /> ro <br /> Contact's Email:northland001@centurytel.net N <br /> On <br /> Legal Description of Property:NW SE EX PCL DESC 464172trq <br /> 0 <br /> Section#:24 Town#:40 N Range#: 15 W Town of:Jackson : <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement):35615 F <br /> house = o <br /> Proposed Use of Structure/Addition: -` <br /> Anticipated Start Date:June (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) '-3 k. V" <br /> Building Contractor: Norhland Buidlers Inc Sewer Installer:Hopkins Sand and Gravel <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: J <br /> XI <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkho ses ** <br /> /1i k cul Qc.5 / <br /> D4rell, /104-1v erCe ec( 3 bee(t'oa/k$ peiM.r" " ?•' "?-ti s Fee Rec: <br /> Check#:.32ta-, <br /> Date of staff site visit: q ll q(?-6) Initials of ite visit taf { 0 y <br /> z <br /> /l c , <br /> APPROVED BY LAND SERVICES OFFICIAL: ��. _' l Ar /� DATE: 1�r p� , _.,,C...;,1 <br /> UPON APPROVAL: APPLICANT'MUST POST COPY OF an <br /> m03 -v <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> r co o .. aY�+ <br /> C <br /> Pagelof5 x <br /> Burnett County,WI Land Use Application—Rev 12/2021 < g ^' <br /> d 3 <br /> t <br /> a <br />