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LAND USE PERMIT APPLICATION — Burnett County, WI - <br /> a g <br /> b <br /> Applicant Complete All Sections Below This Line 0' <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $2001 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ' �"O <br /> X Accessory Structure(Garage,Shed,etc.) ISIS() Addition/Alteration to Accessory Structure $150 1 'J o <br /> Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Iuu" <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 t=, <br /> Filling/Grading $150 Boathouse $500 ° <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 r IJ <br /> i <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 /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Q <br /> ,, <br /> Property Owner's Name: Jason and Monica Gabrick z <br /> Property Owner's Mailing Address: 4 719 S S . Lake Sarah Dr . Independence, MN 55359 - <br /> City State Zip w <br /> Property Site Address: 7000 S . Devils Lake Dr . Webster, WI <br /> Sontact's Telephone Number: (612) 360-3251 Z ° 0. <br /> -ontact's Email: jason . gabrick@ryancompanies . com <br /> Legal Description of Property: see attached for legal description N ' <br /> It <br /> Section#: 03 Town#: 39 N Range#: 16 W Town of: Me e non w <br /> C <br /> 'Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Fax ID#(1-5 digit number; found on tax statement):0 7—018—2—3 9—16—0 3—5 05-003-024000 cA <br /> ?roposed Use of Structure/Addition: 10 7x12 ' storage shed + 10' ),, i D ' Lea — p - �. <br /> 7 . 28 . 20 x <br /> knticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C <br /> 3uilding Contractor: Self Sewer Installer: N/A <br /> r-- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONINIENTS/CONDITIONS ONLY `— <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r— <br /> a Sd /\Jl , r //rimaY1 � 7ort x d <br /> fiolto� pto-A-mck..1,\ <br /> s Fee Rec: <br /> % AY— 7 Check#: .72T2-. <br /> , , ;,� r- <br /> Date of staff site visit: �' Initials of site visit staff: <br /> rn <br /> z. <br /> r <br /> ��. C 1 <br /> kPPROVED BY LAND SERVICES OFFICIAL DATE:5-7 < �R <br /> , Fitt <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT T <br /> z , L��., <br /> - ,a -- =A <br /> Transcendent: Page 1 of 4 m , - o <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2019 <o <br /> j <br />