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LAND USE PERMIT APPLICATION-Burnett County, WI g b <br /> Applicant Complete All Sections Below This Line a <br /> 0. <br /> Permit Types and Fees:(Please,check appropriate boxes) d Q-- <br /> CD <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 p(� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 , \ O <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 /> C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 't=- <br /> Filling/Grading $150 Boathouse $500 a <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 d <br /> 0 <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. c. g <br /> 0 <br /> z <br /> Property Owner's Name: Brian&Pamela Wilson P i <br /> Property Owner's Mailing Address: <br /> 27763 520 St;Pine Island MN 55963 0. <br /> City ate Zip CA ' <br /> Property Site Address: 28617 Crescent Lake Lane Webster <br /> Contact's Telephone Number: 507-951-5633 or 507-273-4245 <br /> 0 <br /> o - <br /> Contact's Email: wilsonwilson22@aol.com . <br /> Legal Description of Property: Part of WI/2 of SE1/4&the SE1/4 of the SW1/4 Section <br /> #: 16 Town#: 40 N Range#: 14 W Town of: Scott Str Burnett Co = pp ` <br /> d �7 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* �. Q <br /> 0 <br /> Tax ID#(1-5 digit number;found on tax statement): 18101 Lot 1 CSM3381 V16 P202#315720 <br /> Proposed Use of Structure/Addition: Pre-Built shed for storage 12x24 moved to our property <br /> Anticipated Start Date: 8/30/2022 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) / 1---c4 0 p <br /> Old HickoryBuildings NA �/`' -3 <br /> Building Contractor: g Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c. . 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 <br /> O�(`n_ e en a I/ �P+c,/r�� z <br /> Poi" ££ hi4 ma 4 114 b jack cA <br /> In a:4 ;A l'elitidioil on 5iwri yle 14 O4COIck n ce c 4 <br /> si'atfc. 74 tir <br /> Fee Rec: 15619 <br /> Check#: c2 .9 <br /> t. <br /> t n d <br /> Date of staff site visit: 7 .2 CJ (22. Initial of site visi staff: )1 1-- a <br /> _ z • <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Q/�gh3 < " <br /> r) <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a m W <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> Transcendent: - Page 1 of 4 , i' 7 <br /> Laserfische: - Burnett County,WI Land Use Application-Rev 1/2019 tri 3 <br /> m a <br /> 0 <br />