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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> I . y b <br /> tJ <br /> Applicant Complete All Sections Below This Line 0' G N <br /> Permit Types and Fees:(Please,check appropriate boxes) ` / IDwelling/Principal Structure $300 �/ Addition/Alteration to Dwelling/Principal Structure $200 u\ <br /> Commercial/Industrial Structure $300 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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> ^ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 E ; <br /> Filling/Grading $150 Boathouse $500 ,% <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 g. <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. itk <br /> Property Owner's Name: <br /> Liana Kvidera o . `` <br /> vc V <br /> Property Owner's Mailing Address: 29116 Pardun Rd, Danbury WI 54830 C q„� <br /> City State Zip �� <br /> Property Site Address:29116 Pardun Rd,Danbury WI 54830 o In <br /> a <br /> Contact's Telephone Number:651-605-5017 <br /> Contact's Email:loe.kvidera@gmail.com <br /> N 'o <br /> go <br /> Legal Description of Property:Plat of Riverside Homes Lot 18 S <br /> 06 40 16 Oakland <br /> Section#: Town#: N Range#: W Town of: o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement):14876 <br /> liscz c <br /> Proposed Use of Structure/Addition: Bedroom <br /> Anticipated Start Date:Existing (Home/Cabin;Commercial Business;Bedroom;;Deck;etc.) H <br /> Building Contractor:prior owner Sewer Installer:Existing/Wade Rufsholm <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> ,::. aaa)/a;a tr.a arr et/,to z aarat e, /their I i C.latspect r io determine i/a pe.rmitis needed f om them prior i 'ro <br /> JNI z grastr°uc tren tak/n,'place for any dwellings,dwelling additions,mand/twtared homes,manujam red ',.. <br /> tac;rrar addition', <br /> oMeC d b ,�o,�5 « s v- ,- ? I©J 4C(I2 .j <br /> ' of exCe , (Q %- <br /> A/ ID t De✓I'n p/ Ieetaie 6/l 3 Fee Recop T Check#: O 7 <br /> r ^� G 1 <br /> Date of staff site visit: 1 I 243 7? Initials of s' visit sta : j1 f �i A T <br /> q__\ . iAPPROVED BY LAND SERVICES OFFICIAL: I s• DATE: 12 ! / ? 2 1 <br /> 3 s <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> CV SIGNED PERMIT APPLICATION IN PLAIN SIGHT v o M41 'v <br /> Page 1 of 5 p m cn <br /> Burnett County,WI Land Use Application—Rev 05/2022 I <br /> co <br />