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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> a � <br /> Applicant Complete All Sections Below This Line o' N <br /> Permit Types and Fees:(Please,check appropriate boxes) Q <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .9 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 "9 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 _9 O <br /> Accessory Structure(Commercial/Industrial F <br /> $200 Addition/Alteration to Bunkhouse $150 c1\ �; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 a <br /> Filling/Grading $150 Boathouse $500 0 <br /> r— <br /> Six Month Camping Unit One Per Year P g ( ) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fad permits(permit aquired after construction has begun)may cost up to three times the normal fee. v <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. m <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Kenneth S and Melissa J Busby <br /> PropertyOwner's Name: � - <br /> z <br /> 0 <br /> Property Owner's Mailing Address: 28645 Crescent Lake Ln, Webster, WI 54893 0 <br /> 0 <br /> City State Zip <br /> Property Site Address:28645 crescent Lake cn <br /> <60 600. 24 <br /> Contact's Telephone Number:715. — <br /> a N <br /> Contact's Email: momentum.ken@gmail.com _a <br /> 'y <br /> Legal Description of Property: LOT 5 CSM#3382 V16 P206 (NW SE)#315721 <br /> Section#: 16 Town#: 40 N Range#: 14 W Town of: SCOtt 2 <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ro <br /> g <br /> Tax ID#(1-5 digit number; found on tax statement): 18105 <br /> Proposed Use of Structure/Addition: Storage Shed <br /> Anticipated Start Date:September i,2020 (Home/Cabin:Commercial Business:Bedroom:Deck:etc.) o X <br /> F <br /> Building Contractor:Self Sewer Installer: N/A o <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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.froni thein prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured hoines,manufactured z <br /> Koine additions,and bunkhouses.''° <br /> �'° <br /> s Fee Rec: �a <br /> r Check#: <br /> Date of staff site visit Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIA#-%Q 'OZ <br /> m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r-> <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT C77 <br /> Transcendent: - Page I of n it <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 6/2020 r ; c <br />