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t LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> 1' 1 LJ <br /> Applicant Complete All Sections Below This Line co <br /> CD D <br /> Permit Types and Fees:(Please,check appropriate boxes) --c-�' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 p, <br /> sIN <br /> Commercial/Industrial Structure $300 _Addition/Alteration to Commercial/Industrial Structure $200 ,4 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 • O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> s.._ �\ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n b <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 I . <br /> Cl) <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 /> ‘--- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> r3 <br /> Property Owner's Name:Bob abd Kathy Humphrey ° <br /> p <br /> Property Owner's Mailing Address: 159 Hallam Ave S Mahtomedi MN 55115 <br /> City State Zip <br /> Property Site Address:29055 Hanscom Lake Trailway Danbury WI ' Cl) <br /> Contact's Telephone Number: 715-259-3257 (Northalnd Builders Inc.) o <br /> Contact's Email:northland001@centurytel.net d 1` <br /> Legal Description of Property: Lot 3 Aspen Green Add to VV <br /> Section#:7 Town#:40 N Range#: 14 W Town of:Scott N o0 <br /> a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> J <br /> Tax ID#(1-5 digit number;found on tax statement): 19248 <br /> Proposed Use of Structure/Addition: Garage Ln <br /> -. <br /> Anticipated Start Date:July (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> Northalnd Builers Inc NA <br /> BuildingContractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: "3 <br /> **The applicant needs to contact their UDC Inspector to determine if a pennit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z oq <br /> home additions and bunkhouses.** x <br /> d t'Jok-- F=oF' 1A-volY\a v D c �o- <br /> dp inClar\ -4\: nin�q 1© c405\- `i de c �C.k 7Ybri <br /> pro yr- L Y\e % s oil-% ca` <br /> Cc I <br /> �er1r g/ Ar r� /7EFee Rec:atip IGY1 Check#:31257 <br /> -7_ r 04..►. r p ic_______ Co <br /> Date of staff site visit: m :Is of site visit staff: <br /> z <br /> ,' t <br /> _ <br /> APPROVED BY LAND SERVICES OFFICI• : i • "' ': l©�-96RG < w ��� <br /> P APPROVAL: APPLICANT MUST POST COPY OF ' rD m <br /> UPON O C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z <br /> r oc N <br /> Transcendent: Page 1 of 4 R .7 <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 m 3 <br /> a L moi <br />