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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI 1 g g b <br /> ~ N <br /> Applicant Complete All Sections Below This Line 0 PO w <br /> a- <br /> Permp Types and Fees:(Please,check appropriate boxes) a <br /> XDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 w <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 e) <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 S <br /> Filling/Grading $150 Boathouse $500 rn E <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 P. p <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. b <br /> *Communication Towers,Camping Permits&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. b "' <br /> z <br /> NI <br /> Propert\ Owner's Name: SM Wolf Holdings LLC -,10 o <br /> 8 <br /> 19200 CountyRoad 40, Belle Plaine, MN 56011 E. mot`',, <br /> Property Owner's Mailing Address: <br /> `City State Zip E D <br /> Property Site Address: TBD Deerpath Road 4311 Zr Ka. Z c r r <br /> Contact's Telephone Number: 952-994-6924 _ .* a R <br /> 0 <br /> w <br /> Contact's Email:timberlandcottages©gmail.com <br /> **It'staff has a question about this application,you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following addresses: (aBurnettCounty.org and 5, °Q <br /> (a:.BumettCountyWLgov Lot 203 Deerpath Addition to Voyager Village c <br /> Located in the NE 1/4 of the NE 1/4 and the SE 1/4 of the NE 1/4 <br /> Legal Description of Property: s. <br /> Section#: 10 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.* o X' <br /> V 0 g <br /> Tax ID#(1-5 digit number;found on tax statement): 6895 (A <br /> - !) <br /> Proposed Use of Structure/Addition: Home/Cabin <br /> Anticipated Start Date: 9/21/23 (Home'Cabin;Commercial Business;Bedroom;Deck;etc.) O <br /> Building Contractor: SM Wolf Holdings LLC Sewer Installer: Corti' Jackson Plumbing <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • &,- ca St+tc, -s <br /> • btAral tv 11..04 -o t X,c.04A 3 bectrocxYLS f2e./ S - 23- 148 <br /> Fee Rec: 3EXP- <br /> 6 C'heck#:oil <br /> rri <br /> J 1 <br /> Date of staff site visit: 71 (ilIze23 Initials of site visit staff: I Q. Ertni <br /> LL <br /> APPROVED BY LAND SERVICES OFFICIALg` DATE: 1/ZU/ZOz3 Z. 0 <br /> 0 CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Cr) -M- <br /> oc o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w <br /> co tin <br /> Page l of 5R - <br /> L.Burnett County, W 1 Land Use Application — Rev 5/2023 � JJ <br />