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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 $300Addition/Alteration to Dwelling/Principal Structure $200 <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 Addition/Alteration to Bunkhouse $150 <br />X Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension -Allowed Once) $100 <br />*NOTE: After -the -fact permits (permit aqui red 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, landscaping, etc. <br />Property Owner's Name:—Benoit Lake Campground/Jodi Thieman—Derrick <br />Property Owner's Mailing Address: 803 North Fourth Street, Saint Peter MN 56082 <br />City State Zip <br />Property Site Address: 1980 County Road G, Spooner, WI 54801 <br />Contact's Telephone Number: 507-934-1200 (home) 507-317-6374 (cell) <br />Contact's Email: benoitlakecampground Wail com a `�%� �./ % <br />r <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: <br />Anticipated Start Date: Sl/—)5 (Home/Cabin; Commercial Business; Bedroom; Deck,, etc.) <br />s <br />Building Contractor: Sewer Installer: <br />AREA BELOW THIS LINE FOR LAN SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit: Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIA DATE: <br />UPON APPROVAL: APPLICANT 4ST 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 />ro <br />a. <br />0 <br />G <br />n <br />o <br />^� <br />G1 <br />�0 <br />o <br />F <br />ro <br />o <br />0 <br />0 <br />0 <br />a <br />w <br />n <br />o <br />G <br />a. <br />b <br />o <br />� <br />5' <br />d <br />n' <br />o <br />w ti <br />7�- <br />U-) <br />v <br />z W <br />r <br />x Fee Rec: 3VA <br />i <br />d <br />m <br />C`- 3C <br />n <br />W N <br />Q Ul <br />N <br />0 <br />co <br />