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so <br /> 11 <br /> LAND USE PERMIT APPLICATION — Burnett County, WI cr cr _ <br /> K N <br /> Applicant Complete All Sections Below This Line 8 n �;' <br /> Permit Types and Fees:(Please,check appropriate boxes) d fy�• <br /> v '& <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `? <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 XX Addition/Alteration to Accessory Structure $150 y <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 t� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 1���^iii <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 E `" <br /> Filling/Grading $150 Boathouse $500 c n <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 °EF <br /> 1 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. 1 <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. _v <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. I K. <br /> z <br /> Property Owner's Name: Marc and Renee Nelson =' <br /> I E. <br /> Property Owner's Mailing Ai ddress: 13498 Brass Pkwy Roesmount MN 55068 <br /> k' k✓t (-1" City State Zip E w ,t <br /> Property Site Address: 3` 7 r I it � o <br /> C <br /> ( a _ <br /> 612)275-7701 ' ") <br /> Contact's Telephone Number: d 4 j <br /> Contact's Email; Sean@LennoxBuildersllc.com 0 <br /> **If staff has a question about thus application.you will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept entails from the following addresses: r�l-BurnettCounty.org and _ V <br /> aBurnettCountyWI.gov d A3 r--' <br /> Legal Description of Property: Lots 2&3 of Kilkare Green v <br /> Section#: 13 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 properh'page.* V° <br /> Tax ID#(1-5 digit number;found on tax statement): 34 9,(°� 1 y <br /> Proposed Use of Structure/Addition: Future Living Space on Cabin <br /> Anticipated Stan Date: 9/25/2023 (home Cabin;Commercial Business;Bedroom;Deck;etc.) G 1) <br /> Building Contractor: Lennox Builders LLC Sewer Installer: Iz J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY x D. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> f <br /> iv eek� Q i( 5e1-b4d4s <br /> o.Me((r' 4D �kc'e eJ 3 b n, er 5�-N' 15 15 7 <br /> ica, I I)el LI SIC 141••1 k x Fee Rec:•204767- <br /> - <br /> r d Check#: 4� <br /> pe-}\,,,G� ea.rce..I s, fr <br /> 6 f f/�4 <br /> y <br /> 6 <br /> Gil Date of staff site visit: I Initia .of si v'sit staff: H / ��L____- <br /> r N r <br /> APPROVED BY LAND SERVICES OFFICIA DATE: 1�l yia3 cx �— <br /> fl <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT : o 0 <br /> Page l of 5 w <br /> Burnett County, WI Land Use Application—Rev 5/2023 d . 11 <br /> 5 <br /> L <br />