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LAND USE PERMIT APPLICATION —Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line c cn <br /> Permit Types and FeestPlease,check appropriate boxes) a <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 EI <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(ly)Structures $350 r �? <br /> o v1 <br /> Filling/Grading $150 Boathouse $500CL <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <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. r z <br /> 0 <br /> Property Owner's Name:JERALD AND ROBYN GUNDERMAN "� W 0 <br /> 808 PARK LN SOUTH ST PAUL MN 55075 N <br /> Property Owner's Mailing Address: W <br /> City State Zip o <br /> Property Site Address:27496 HILL RD <br /> Contact's Telephone Number:715-651-0350 a <br /> 0 <br /> w <br /> Contact's Email: northland001@centurytel.net N <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 Q <br /> CP <br /> Legal Description of Property:LOT 2 CSM #2120 V12 P33 d W <br /> Section#:36 Town#:40 N Range#:14 W Town of:SCOTT a W 00 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. 7,1 <br /> o � <br /> Tax ID#(1-5 digit number;found on tax statement): 18872 A W <br /> Proposed Use of Structure/Addition: GARAGE <br /> Anticipated Start Date: (Home/Cabin:Commercial Business;Bedroom;Deck;etc.) U _ <br /> NORTHLAND BUILDERS INC NA rUj' cA <br /> Building Contractor: Sewer Installer: y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N <br /> o � <br /> tO VhEET" A l..t.. �ETBAE.�S � 1 <br /> Q ApT- IV be U%e D Fb lZ I'!tJ K4oq/V MMirm-rI oru <br /> m <br /> y <br /> a <br /> � Fee Rec:_�,� <br /> z Check#: 33.7y <br /> r <br /> •C <br /> �n <br /> n <br /> m <br /> 2 -- <br /> Date of staff site visit: Initials of site visit staff: -- <br /> �, m <br /> CL <br /> C <br /> APPROVED BY LAND SERVICES OFFICIAL: t DATE: 9 z`f 2 m <br /> UPON APPROVAL: APPLI NT MUST POST COPY OF C= M <br /> 00 C o <br /> SIGNED PERMIT IT APPLICATION IN PLAIN SIGHT C <br /> Page I of 5 C <br /> Burnett County, WI Land Use Application —Rev 07/2025 U <br />