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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> Applicant Complete All Sections Below This Line g • <br /> Permit Types and Fees:(Please,check appropriate boxes) I v a `�tom, <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 v "_"t\ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> '\ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,17 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 iC <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 _ Permit Extension(1 Year Extension-Allowed Once) $100 L <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. 5 <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. z Ilk <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: Kevin &Katerina Strom — , <br /> Property Owner's Mailing Address:_10639 Silver Lake Road t. 1 n v <br /> City State Zip K <br /> Property Site Address: 10639 Silver Lake Road Grantsburg WI 5484Q < y <br /> 612-360-0539 a <br /> Contact's Telephone Number: t <br /> Contact's Email: kvnstrom@gmail.com <br /> **If staff has a question about this application, you will be contacted via email. Make sure your email address is IN <br /> legible and your email provider will accept entails from the following addresses: @BurnettCounty.org and 0, v� <br /> @B urn ettCountyA'I,gov t <br /> d C <br /> Legal Description of Property: Lot 1 CSM V21 P09 (# 374180) (GOV Lot 2) i, .p <br /> Section#: 36 Town#: 38N N Range#: 18 W Town of: Wood River 7D, s <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): 29414 d <br /> Proposed Use of Structure/Addition: Home will-lb/1 + keep (- <br /> Anticipated Start Date: 09/01/23 (Noma/Cabin;(Aunercia!Business;Bedroom:Deck;etc.) - <br /> Building Contractor: BJL Construction Sewer Installer: -r___ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> /',-CreA- ail eoweelit 1� 40 ekc ; becitons Per sMV- l7- Ila <br /> Fee Rec. <br /> 6 Check#: &.O <br /> tr <br /> a <br /> Date of staff site visit:8l/II I d3 I 'dal'of site sit staff:jle ' l iUUnJnui <br /> /��3 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: //b .-1 co 1> <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> c., cn n . <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o K < <br /> Page 1 of 5 < 3 M <br /> Burnett County, WI Land Use Application- Rev 5/2023 < �. I <br /> 4 <br /> ro <br />