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x <br /> . LAND USE PERMIT APPLICATION —Burnett County, WI a a <br /> N in b <br /> it,,) <br /> Applicant Complete All Sections Below This Line o 1 <br /> Permit Types and Fees(Please,check appropriate boxes) p <br /> xx Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ,, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> � <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 � <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Bunkhouse $250 , p <br /> 111/ <br /> O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk -- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 _ Permit Extension(1 Year Extension-Allowed Once) $100 a 11, <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. by <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. r- C , <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ° z 1 <br /> p <br /> N <br /> Property Owner's Name: Doug Hanson o -L <br /> Property Owner's Mailing Address: 13853 Washington St NE Ham Lake MN 55304 0 UN, <br /> City State Zip cn <br /> Property Site Address: 07-012-2-40-15-695-110001 2..$g2( S(-}4i11.0t CiAn C+ z o <br /> .a <br /> Contact's Telephone Number: 612-558-1515 d <br /> w <br /> Contact's Email: DOughanSonl@yahoo.com N <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is oN <br /> N <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov =. <br /> Legal Description of Property: Rl lrnAtt County 1-11N(1 UN 0 It NOYAbeg V 1111466 LoT i D d <br /> Section#: 9 Town#: 40 N Range#: <br /> 15 W Town of: Jackson N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p „, <br /> Tax ID#(1-5 digit number;found on tax statement): 8207 '—.t. � o <br /> Proposed Use of Structure/Addition: New Home Vacation Property -� <br /> 0.9 <br /> Anticipated Start Date: 3/1/24 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Doug Hanson Homeowner Sewer Installer: Jackson Plumbing 7, o3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> /1)7/1fd 011 e,"fildS rri <br /> Ul <br /> irDwo.a7 of _it ace,td 5 beffrayris pei SIN -2 41 25 F, <br /> Fee Rec: <br /> ° Check#: 4� <br /> 19 Dwc, j(1 cowl ttc4" '1o4 in hP.+,9 <br /> Date of staff site visit: sts/zozy Initials of site isit staff:7‹1 4— 6 L : a <br /> APPROVED BY LAND SERVICES OFFICIAlaiittii DATE: 3/7 li(/liy : m W r n <br /> < 3 C7Cs V�/ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF �va 0 N UW <br /> 0o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT roc IV <br /> lnn] <br /> Page 1 of 5 LL JJ <br /> Burnett County,WI Land Use Application —Rev 12/2023 <br />