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1 <br /> LAND USE PERMIT APPLICATION —Burnett County, WI a• <br /> Applicant Complete All Sections Below This Line 5 A. •163 <br /> Permit Types and Fees:(Please,check a�pprvpriate boxes) - <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ro <br /> .¢w' Q <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 kAi :; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° �' <br /> Filling/Grading $150 Boathouse $500 o <br /> Six Month Camping Unit(One Per Year) $100 X Permit Extension(1 Year Extension-Allowed Once) $100 W a <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 1S, <br /> k <br /> *Communication Towers&Signs require a dfferentapplication form;see corresponding appication,and fees. $ <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Justin M Greiner <br /> Property Owner's Name: o <br /> lb <br /> Property Owner's Mailing Address: 16028 Ironstone St NW Ramsey MN 55303 a <br /> City State Zip <br /> Property Site Address: 14088 Bistram Rd Granstburg, WI 54840 oT 1cn <br /> Contact's Telephone Number.612 508-3290 <br /> a <br /> ustin. refi@ il.com My Card ;0I 0,,%s - hqS p`N a <br /> Contact's Email:l gner 9ma d <br /> Va. <br /> Legal Description of Property Sec 27 Tn 39 Rg 19 LOT 2 C: reS `G � i"'\e- -F_O^'1 /1 1 eat`/ <br /> 27 Town#: 39 NRan a#: 19 W 1abar 5 0 J anti novv wokkcl�c = -a <br /> Section#: g t -- <br /> *Attach additional page if needed for lerwliy description OR attach a co- IA/, �k'r O c li'W (i, ` <br /> Tax ID#(I-5 digit number,found on tax statement):35137 1 <br /> S h4 a,,j, will need +9 5414 <br /> Proposed Use of Structure/Addition: Shed <br /> Anticipated Start Date: 6/14 Hume/Cabin; St) a <br /> permG <br /> Building Contractor n/a S �hq"v` 'i -I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF <br /> THIS PERMIT IS SUBJECT TO ALL CO:` � )-\ <br /> *The applicant needs to contact their UDC Inspector to d C.A.) <br /> construction taking place for any dwellings,dwelling a Z N <br /> home additions,and bunkhouses. x <br /> gTheek- c 11 5ekb <br /> IUo-,',{ k is 4 ha hd" <br /> Fee Rec:1,C2C05 <br /> C <br /> Check#: 114/ <br /> //'' ,J <br /> Date of staff site visit: 10 1 13 �� � r Initials site visit IT: n <br /> APPROVED BY LAND SERVICES OFFICIAL: ,e DATE: W13/? 3 <br /> �0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF A a ` n <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z = ? % <br /> -C cn 0IV u <br /> Transcendent Page 1 of 4 g = o <br /> _ - Burnett County,WI Land Use Application—Rev t2/2020 2 3`` w <br />