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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> y• <br /> Applicant Complete All Sections Below This Line p 4 <br /> Permit Types and Fees(Please,check appropriate boxes) Ce. <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P <br /> J It Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 � <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 P <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 )( WI State Statute 59.692(1v)Structures $350 r' A <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> .f. <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `1 <br /> *Communication Towers,Camping Permits&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. r <br /> z <br /> • <br /> Property Owner's Name: Scott and Kathleen Hagstrom 'N <br /> F. -L <br /> G. 1 1 <br /> Property Owner's Mailing Address: 16330 South Hillcrest Court Eden Prairie MN 55346 �, <br /> 3854 State RD 77 DanburyStateWIZip < — i <br /> Property Site Address: WI 54830 - o ., <br /> Contact's Telephone Number: <br /> 952-270-2085 p.. <br /> Contact's Email: scottonthelake@gmail.com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is 1 I <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov B °o <br /> SWi' <br /> Legal Description of Property: N 500' OF NE SE EX W 200' S' <br /> 4. <br /> Section#: S 13 Town#: T41 N Range#: R15W W Town of: 5 W I SS -` <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Cl <br /> Tax ID#(1-5 digit number;found on tax statement): 21355 v. <br /> Proposed Use of Structure/Addition: Cabin H <br /> Anticipated Start Date:Juiy y 2024 (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) <br /> Building Contractor:Focht Custom Homes Sewer Installer: Dennis Rasmussen n <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> D '.c no-4 -Ft .ex(e e 13 bed.raoinS pe-r SIN-2L1 •!11) . �, <br /> d Follow 1xLUt fe u.i re,nu,+'ti-iS 4 &kat S-(u.-lut Gel.02(iv) <br /> �J (i ini 1/0-1t)(c d 40P-1 IY UA CJ 114 as (-4"' ' Fee Rec <br /> ° Check#: '] <br /> . 35b9 <br /> (.Kit 131..t <br /> r <br /> Date of staff site visit: (p11[12`( Initials of site visit staff: 61-4- r-- <br /> r SW111ia --.3 <br /> APPROVED BY LAND SERVICES OFFICIALS%�ta DATE:1"f 2(1 2-02/I cni>co <br /> CD UPON APPROVAL: APPLICANT MUST POST COPY OF 3 <br /> cn Cm <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a= C r.-.a <br /> Page 1 of_5 � If if <br /> Burnett County, WI Land Use Application -Rev 12/2023 - �J <br />