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LAND USE PERMIT APPLICATION — Burnett County, WI a _ <br /> N. N <br /> Applicant Complete All Sections Below This Line o CD w <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) a C7 f <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 CD <br /> '`) <br /> C—" <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 � V` <br /> X <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0- VVV��` ' <br /> li <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 r <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 _ <br /> ' <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. rc7 71 <br /> z 1 <br /> Property Owner's Name: BOROWSKI FAMILYLIVING TRUST c P <br /> Property Owner's Mailing Address:108 LORETTA LN MAHTOMEDI MN 55115-1876 E. <br /> City State Zip 3 <br /> t <br /> Property Site Address: 3539 RIGBY RD WEBSTER 54893 ...... <br /> Contact's Telephone Number: 715-816-4676 - <br /> Contact's Email: Shanebegley(a,begleywireless.com -� o �' <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 0 e <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and �� <br /> @BurnettCountyWI.gov o r <br /> Legal Description of Property:LOT 2 CSM V 10 P 35(IN GOV LOT 5) d o <br /> ,7;' 0 R. <br /> Section#:13 Town#:40N Range#:15W Town of:Jackson -,. ii <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> 70 <br /> Tax ID#(1-5 digit number; found on tax statement): 5283 x <br /> W � d <br /> Proposed Use of Structure/Addition: Bedroom,Deck,Kitchen,Bathroom C4 <br /> '-' <br /> Anticipated Start Date: 10/01/2023 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) OQ <br /> W <br /> Building Contractor: Professional Exteriors and Interiors Sewer Installer:Jackson Plumbing 0 <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 70 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> 0 Mk+ au Se.-Kx�c,ks 0 <br /> V L t j no+ 40 -mud. 3 b&ivocni per Si-N -23 -201 <br /> 3 Po4io -b (efface, er€viou,S ottc,k iii -►{A Sawa. -boo+pr1Yt+ �' <br /> x Fee Rec: Z4`, —' <br /> 4 Check#: 32.7 7 <br /> Deck Yl o i- 40 Mad 6 - -From d .t t'2) Or 4 7347°rd4 rear y #1'S 11 Walle-r <br /> V /�/ (ONWIVI cult a <br /> ` <br /> Date of staff site visit: l 1 Initials of sit visit sta C <br /> APPROVED BY LAND SERVICES OFFICIA DATE: /0/ �» --1 <br /> g NI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 12 CAINJ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3. <br /> Page 1 of 5 < � <br /> Burnett County, WI Land Use Application—Rev 5/2023 h ./ <br /> En <br />