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LAND USE PERMIT APPLICATION—Burnett County, WI b r <br /> a � b e' <br /> Applicant Complete All Sections Below This Line o' <br /> C <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 SO <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 'N <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(1v)Structures $350 r- <br /> Filling/Grading $150 lBoathouse <br /> $500 <br /> Six Month Camping Unit(One Per Year) $100 1 jPermit Extension(1 Year Extension-Allowed Once) $300 <br /> *NOTE:After-the-tact 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. -o <br /> * CD <br /> Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Penn Streif on T o <br /> Property Owner's Name: y Lyon <br /> 0 <br /> Property Owner's Mailing Address: 18027 62ND Ave N Maple Grove MN 55311 <br /> City State Zip <br /> Property Site Address:29431 County Rd H <br /> Contact's Telephone Number:715-259-3257 ° <br /> a <br /> Contact's Email:please contact northland001 @centurytel.net with any questions d <br /> Legal Description of Property:OL 2 CSM 26/219#4754 0 <br /> Section#:04 Town#:40 N Range#: 14 W Town of:Scott <br /> t7 <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):34852 <br /> Proposed Use of Structure/Addition: Storage o <br /> Anticipated Start Date:September (Flome%Cabin;Commercial Business;Bedroom;Deck;etc.) d <br /> Building Contractor: Northaind BuidlerS Inc Sewer installer: NA a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CO DITIONS LISTED BELOW: t:�, <br /> Fee lRec: D <br /> � � Check <br /> Date of staff site visit: I of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIA DATE: CL <br /> C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF E (cc' m C� <br /> H < <br /> S' n N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> N W <br /> ZZ vo 0 <br /> r CM <br /> Transcendent: - Page 1 of 4 X a` u <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 3 <br />