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LAND USE PERMIT APPLICATION—Burnett County, WICr <br /> Applicant Complete All Sections Below This Line p '4 tti <br /> Permit Types and Fees:(Please,check appropriate boxes) R. <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 w <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200c 1� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 "` <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 a <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 I— <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o y <br /> Filling/Grading $150 Boathouse $500 c h <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. �a \ <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 /> Property Owner's Name: Webster DG, LLC o <br /> U r <br /> Property Owner's Mailing Address:361 Summit Blvd.,Suite 110 Birmingham,AL 35243 <br /> City State Zip b <br /> Property Site Address: TBD- Pending lot split p' <br /> Contact's Telephone Number: 205-968-9220 ? yE• r�,`� '� <br /> n V <br /> Contact's Email: dyance( cgpre.com d <br /> Legal Description of Property:See attached (" <br /> b <br /> Section#: 16 Town#: 40 N Range#: 14 W Town of: Scott ' <br /> 01 � . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properly page.* C. `" <br /> Tax ID#(1-5 digit number;found on tax statement): - - - - - - 0 i 0°495 . <br /> Proposed Use of Structure/Addition: Retail store `n <br /> Anticipated Start Date:July/August 2022 (Horne/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> U <br /> Building Contractor:TBD Sewer Installer:TBD V\ <br /> n <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> 4:, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 4 <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to ,^,a <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhot ses. * Pd <br /> d ee4 0.61 s 4f. •4 Pee 4 Meo.. <br /> d "u5+ A a/ 5 0rl -c eVe/ s <br /> • •e v40e AIL* bee .e b ,fQ/1!1. 4v 5 t+ Alo+ . <br /> Geri+ AIL* tt r r <br /> 'il ver/X• t v1 �ttde5 Si lS A 1!J j/1 4Le pI4?1 . H Fee Rec. C <br /> '}' i nryper CernillerCi4i�;4Spec cIn5• 1.1 Check#: y,' 5 <br /> Date of staff site visit: ✓��l l�a mitt {s site vis' s. • t 1--- <br /> APPROVED BY LAND SERVICES OFFICIAL: /� DATE: 5 //c[ G).` <br /> 8 o <br /> UPON APPROVAL: APPLICAN ' UST POST COPY OF 9 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ifiil <br /> z 3 IS 0 <br /> Transcendent: - Page 1 of 4 , '1 <br /> a N r" <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 v c LID �' <br />