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LAND USE PERT APPLICATION—Burnett County, WI r <br /> 6 <br /> O y <br /> Applicant Compiefe All Sections Below This Line <br /> a. 'o <br /> Permit Types and Fees:fn m 4 check gWmpri`ete banes) t7 <br /> Dwelling/Principal Structure 5_" Addition/Alteration to Dwelling/Prindpai Structure $200 v <br /> Commer ial/industrW Structure SM Addition/Atteration to Commerdal/industriai Structure SMO <br /> Access Structure(Garage.Shed,etc $150 �c, Addition/Alteration to Arne Structure $M <br /> Accessory Structure(Conmercial/industrial) $2W Addition/Alteration to Bunkhouse $Z50 <br /> Dedr/Stairs/Patio/Retaining WUf/Sidewalk Bunkhouse50 <br /> Driveways/&Campground Structures $1z VA State Statute S9.682(iv)Structures $350 <br /> Fillip Gradin $5W 0 <br /> 5350 Boathouse <br /> Six Month Camping Unit(One Per Year) S Permit Extension(1 Year Extension-Allonned once) $lOD <br /> *NOTE:After-the-fad permits(permit aquired after construction has begun)may cost up to three times the nt nd fee. <br /> 'Communication Towers&SVns require a dUerent oppkation form;see corresponding app&ntion,and fees. �v <br /> *items not fated above wff be treated as accessory s&udun!s,such as olas,6rdscaping,etc <br /> Property Owner's Name: William&Paula Sherman o <br /> o` <br /> Property Owner's Mailing Address ,f396 BNdvite Drive Rochester MN 55906 a8 <br /> City ZiEF <br /> Property Site Addre%: 27483 Shake Lane Webster 54 93� <br /> Contact's Telephone Number. 507-254-2337 = a <br /> Contact's Emaih wgshennan@gmaii.com v a <br /> Legal Description of Property: LOT 4 C5M VIP 251 �' b <br /> a <br /> Section#:34 Town#: 40 N Range#: 14 W Town of SCOTT <br /> *Attach additional Page if needed for lengthy description OR attach a copy of the deed OR attach tear system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 18821 <br /> Proposed Use of Structure/Addition: 3 Car Garage c <br /> Anticipated Start Date:_ 1011712019 (Hore/Cbbnr;Ceurmaercial Business:Bedroom;Deck-etc.) C7 <br /> Building Contractor: Norseman Superior construction,LLC Sewer Installer. N/A � <br /> AREA BELOW THUS LINE FOR LAND SERVICES STAFF COMMEMVC0NDM0NS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> X <br /> Fee Rec:� <br /> L Check#: � <br /> Date of staff site visit: !I.i" of site visit staff: m <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: DPI D <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> CL SIGNED PERMIT APPLICATION IN PLAIN SIGHT 'W o <br /> _ <br /> Transcendent: 0"— Page 1 of 4 9 N -� <br /> Laserfische:— Burnett County,W1 Land Use Application—Rev 1R019 <br /> g wg o <br /> CD <br /> 3 to fart <br />