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�• �. C r <br /> CD <br /> LAND USE PERMIT APPLICATION - Burnett County, W1 a b <br /> Applicant Complete All Sections Below This Line t! <br /> a <br /> Permit Types and FeestPiease,check appropriate boxes) p 0 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD4� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 V Addition/Alteration to Bunkhouse $150 <br /> G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <_ <br /> X Driveways/&Campground Structures $125 1 jWl State Statute 59.692(ly)Structures $350 0 <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> >v <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 3 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -o <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. <br /> z <br /> o . <br /> Property Owner's Name: Andrew and Nicki Anderson 8 �' <br /> Property Owner's Mailing Address: 'y 54026 n ►�' <br /> City State Zip <br /> Property Site Address: 28637 Crescent Lake Ln Webster WI Z o N <br /> a - a <br /> Contact's Telephone Number: 715-557-2285 d <br /> :v <br /> Contact's Email: andy bossequipment com <br /> **If 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 address: @BurnettCountyWI.gov <br /> Legal Description of Property: Lot 3 CSM V16 P202 (W 1/2 SE, SE SW) #315720 <br /> Section#:�_Town#: 40 N Range#: 14 W Town of: Scott --j <br /> *Attach additional page f'needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number; found on tax statement): 18103 W x <br /> Proposed Use of Structure/Addition: Patio/lean to '— <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> Building Contractor: N/A Sewer Installer: N/A <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> M <br /> S 46de-s <br /> Sh�re,P,�n2 -�-o p <br /> he r2�er�¢-Eec.-%-'d �-r up -1 -G o by { 'ly/�u° Fee Rec: <br /> °z Check#: 09 7 D <br /> < r <br /> m <br /> CL <br /> Date of staff site visit: Z 5 Initials of site visit staff: Pfl > Cn C13 <br /> C=•� <br /> � <br /> APPROVED BY LAND SERVICES OFFICIAL. Q� DATE: Z 2025 CDCn cm <br /> :° w <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> C3a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Pagel of 5 <br /> Burnett County,WI Land Use Application—Rev 11/2024 <br />