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LAND USE PERMIT APPLICATION —Burnett County, WI cr 0. b <br /> Applicant Complete All Sections Below This Line 5' 16�� <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 X Addition/Alteration to Commercial/Industrial Structure $200 Vr <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °e <br /> X Filling/Grading $150 Boathouse $500 c ;� <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. `y <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: Burnett County Government Center c <br /> Property Owner's Mailing Address: 7410 County Road K Siren WI 54872 g <br /> City State Zip $ <br /> Property Site Address: 7410 County Road K, Siren, WI 54872 E. <br /> c <br /> 4 ( <br /> Contact's Telephone Number: (608)546-2411 o <br /> co t <br /> Contact's Email: mgilbertson@kraemerbrothers.com \•- o G <br /> A Parcel of Land Located in the Northeast 1/4 of the t • <br /> Legal Description of Property:Southeast 1/4 and the Southeast 1/4 of the Northeast 1/4. ± <br /> N ro <br /> Section#: 32 Town#: 39 N Range#: 16 W Town of: MeenOn o. °Q <br /> 5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p ^` <br /> F. <br /> Tax ID#(1-5 digit number;found on tax statement):Exempt#: 008-1020421164-06 :J. <br /> J <br /> Proposed Use of Structure/Addition: Public Safety Building <br /> -s -s <br /> Anticipated Start Date: 06/01/2022 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W F el <br /> Building Contractor: Kraemer Brothers Sewer Installer: Antczak Construction `•` <br /> ,_ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY y �1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: kA...0 W <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 •S\ <br /> home additions, and bunkhouses.** 7 <br /> Pot O7 40 be.. ro p t/y ftiewv 'Wei 0 I Yi+,Li 1?-O cioyS, s <br /> 4 e) D bh,iA, v cA vh w 5. fl,tow„> .5 -60i...1 s74,it, co7evtc.r e <br /> C4$ rel./41 .f <br /> N » Fee Rec: /� <br /> 4 Check#: eiI lie <br /> Date of staff site visit: 'f/?.7/242 Z -Fnitials of site visit staff: /-7;-- <br /> z <br /> . 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: ; ,. DATE: 5'Z7/202 ���^ <br /> x iffl <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> r '� <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 <br /> o <br /> H <br /> i' <br />