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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Principal Structure <br />$300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150 <br />I <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />X Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures <br />$125 <br />Bunkhouse <br />WI State Statute 59.692(ly) Structures <br />$250 <br />$350 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />1 Permit Extension (1 Year Extension - Allowed Once) <br />$100 <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. <br />*Communication Towers & 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, landscapinq, etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: 803 North Fourth Street, Saint Peter MN 56082 <br />Property Site Address: <br />untv Road <br />City State Zip <br />Contact's Telephone Number: 507-934-1200 (home) 507-317-6374 (cell) <br />Contact's Email: benoitlakecaMqround@qmail.com <br />Legal Description of Property: Sec 10 Tn 39 Rg 14 <br />Section #: 10 Town #: 39 N Range #: W Town of: Rusk <br />*Attach additional page if 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):15731 <br />Proposed Use of Structure/Addition: SC'"2�<-? C%21/>ov7 -/10/, C/ WC1,14 '/ <br />Anticipated Start Date: //5 ' (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: 6'L� Sewer Installer: <br />AREA BELOW THIS LINE FOR L SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: 1 1 Initials of site visit staff: <br />)Y� 4< - // - /:S> <br />PERMIT APPROVED BY LAND SERVICES OFFICI DATE: <br />UPON APPROVAL: APPLICANT M T POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />< <br />x <br />Fee Rec:`,' <br />� t <br />51 <br />