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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> a - b <br /> Applicant Complete All Sections Below This Line 0. o <br /> Permit Types and Fees:(Please,check appropriate boxes) a- <br /> )tXDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `"per J <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 . ._ O <br /> E <br /> Accessory Structure(Commercial/Industrial)_$200 Addition/Alteration to Bunkhouse $150 g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 r- <br /> • <br /> n b <br /> Driveways/&Campground Structures _$125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 r- 6 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 y <br /> � N. <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. •2 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: Michael & Jean Waltzing Kelly Waltzing (daughter) g : .'CV ° <br /> Property Owner's Mailing Address: 27211 State Road 35 Webster,WI 54893 0 1 1 <br /> ,��rt State Zip <br /> Property Site Addres� t1J�,5r,io Web;ta 4893 next/ 72?�lsir son R pq d,)7Ve6s r <br /> Contact's Telephone Number:715-866-8276 or 715-566-2962 ��"'=5r <br /> P c <br /> Contact's Email:whitetailwilderness@hotmail.com Z — a <br /> 0 6 <br /> Legal Description of Property: PCL govt lot 4 see attached 'i <br /> 31 40 16 W TownOakland N r15 <br /> Section#: Town#: N Range#: of: _ <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 /> Tax ID#(1-5 digit number; found on tax statement): 13868 <br /> F. <br /> Proposed Use of Structure/Addition: Single family manufactured home <br /> ASAP C -i <br /> Anticipated Start Date: (/tome/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Affordable Homes Rice Lk. WI to be determined <br /> Building Contractor: Sewer Installer: t� <br /> �.J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY P <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z OO <br /> hone additions,and bunkhouses.*7• rrm;t c Iy Vo11d lea( csm//o15Pir -- IS <br /> C read 6, and nm- nek&Kin3 d c)ie f Ci ll location • <br /> f1 on c O lrrPo r rn 113 by Oefrobe r t Q) cyaot��c',�. <br /> Fee Rec:d) <br /> Check#:o <br /> V►1 <br /> Date of staff site visit:/- 7 '�„��niti: s of site visit staff: n -AfP <br /> •0 <br /> LAPPROVED BY LAND SERVICES OFFICIAL: 'r : . a "..-0C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 2 E <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Eill <br /> Transcendent: - Page 1 of 4 P w o N <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 <br /> G3 <br /> .- m iiiii <br /> a -• <br /> 1 <br />