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• LAND USE PERMIT APPLICATION--Burnett County, WI cr <br /> .. <br /> Applicant Complete All Sections Below This Line c c o <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> 0 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 XC 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 /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 5 <br /> Filling/Grading $150 Boathouse $500 j <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 L' • <br /> I. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 5F1'*Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- <br /> 0 <br /> z . n <br /> Property Owner's Name:Glenn Doriott -,, <br /> Property Owner's Mailing Address: 4724 Mallard Lake Rd Webster wi 54893 8 <br /> City State Zip F. <br /> Property Site Address:6716 Old A Webster X <br /> < y <br /> Contact's Telephone Number:715-259-3257 (Northland Builders Inc) o a <br /> Contact's Email:glenndoriott@netscape.net <br /> Legal Description of Property:W15 Acres Lyg S of County Rd A Ex W 66'and E 33' in NENE o <br /> I <br /> Section#: 18 Town#:39 N Range#: 16 W Town of:Meenonao <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 5 <br /> n. <br /> Tax ID#(1-5 digit number;found on tax statement):11074 <br /> con <br /> Proposed Use of Structure/Addition: Add on to storage units <br /> Anticipated Start Date:May (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 0 <br /> Building Contractor:Northland Builders Inc Sewer Installer: NA -i <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT��IlISCSUBJECT TO ALL CONDITIONS LIISTED BELOW: --.1 <br /> Ah 54- 4un'ah it aik z <br /> • figw a `6.C,c /e5W 44eal LQjj <br /> Fee Rec. <br /> / / y Check#:!•3( 13 W- <br /> 1 / 1/ m <br /> Date of staff site visit: 1, / � I Ini i is of site visit staff: M � <br /> c <br /> '"---3APPROVED BY LAND SERVICES OFFICIA ►�. , DATE: ✓c I a <br /> vs <br /> < r <br /> fill <br /> UPON APPROVAL: APP ICANT MUST POST CO Y OF U q co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ? yCD INA <br /> . WC N <br /> Transcendent: - Page 1 of 4 R i8 S s IS Q <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 Ngifil <br />