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LAND USE PERMIT APPLICATION — Burnett County, WI ... <br /> g <br /> Applicant Complete All Sections Below This Line °' c N <br /> Permit Types and Fees:(Please,check appropriate boxes) a W' <br /> G <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 �:1 CIO <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> r <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 e <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °r» <br /> Filling/Grading $150 Boathouse $500 <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 =. <br /> w <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. t- <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> -n <br /> Property Owner's Name: Seaen Maria Kosmides a <br /> v 7 iio <br /> Property Owner's Mailing Address: 609 13th Ave NE Minneapolis, MN 55413 5 ci :, <br /> City State Zip <br /> Property Site Address: 28379 Dhein Road Webster, WI 54893 - 1 i ' <br /> a I\ <br /> Contact's Telephone Number: 612-363-5591 0 <br /> Contact's Email: Seaenkaolympiatech.netN b <br /> 0 oa <br /> Legal Description of Property: 28379 Dhein Road o M <br /> P <br /> Section#:24 Town#: 40 N Range#: 15 W Town of: Webster 5. <br /> n <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> v) <br /> Tax ID#(1-5 digit number;found on tax statement): 5555 o <br /> Proposed Use of Structure/Addition: Cabin ° o <br /> Anticipated Start Date: 9-1-2022 (Home/Cabin;Commercial Business;Bedroom;Deck etc.) '3 <br /> P-ine ir'SAI✓-as-/$a <br /> Building Contractor: Anderson Construction Sewer Installer: Taylor Excavating -Septic O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z 3 u„ <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to J <br /> ANY construction taking place for any dwell' s dwelling ad itions,manufactured homes, manuf ctigglo <br /> home additions,and Punkhous s** (y/►/(,4/ yit(, j a non 1)1400,',,ti. LS\ <br /> e10144((, {tie4CNi"(Je b <br /> u17° ref 5o ' FeeRec:�CC� <br /> 0 Dr;rc. y ,,,,,,,,,+- �,Q 4 pt- C I eAI' Act Ail' t/ a Og <br /> wCheck#: 3 Di O <br /> Date of staff site visit: 8 `I a I?-1%) Initi s site vis' s `- <br /> m <br /> 9 L <br /> / <br /> ° <br /> APPROVED BY LAND SERVICES OFFICIAL: 7 DATE: V//la m ' <br /> UPON APPROVAL: APPLICAN -'MUST POST COPY OF - a" � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> Pagelof5 g c <br /> � <br /> Burnett County,WI Land Use Application—Rev 05/2022 < a <br /> a <br /> .ti <br /> Qr. JJ <br />