FOR TOWN USE ONLY: Date Recd __________ Notices Sent __________

Phone: (715) 425-2665 Fax: (715) 425-2551
FEE: $600.00
THIS
COMPLETED APPLICATION FORM, ALL REQUIRED PAPERWORK AND FEES MUST BE RECEIVED BY
THE TOWN CLERK, TOWN ENGINEER AND TOWN ATTORNEY NO LATER THAN THE 21ST
OF THE MONTH. (You will not be heard
at the next Plan Commission meeting, but at the subsequent one).
NOTE: REQUESTS
TO CREATE MAJOR SUBDIVISIONS OF LAND IN THE RIVERWAY DISTRICT ARE ADDITIONALLY
SUBJECT TO THE FEES, FILING SCHEDULES, DOCUMENTATION AND OTHER TOWN
REQUIREMENTS FOR CREATING MAJOR SUBDIVISIONS ELSEWHERE IN THE TOWN.
Applicant Information
Property Owner: __________________________ Engineer, surveyor
______________________________ or contractor: ______________________________
Mailing Address: __________________________ Address: ______________________________
__________________________ ______________________________
Phone #: __________________________ Phone #: ______________________________
E-mail: __________________________ E-mail: ______________________________
Site Information
Street address______________________________________________________________________________
Legal address Section_____Town_____Range_____ Parcel # ______________________________________
Request For (check all applicable lines and indicate all types of permits requested)
___1. Riverway building permit for only
ordinary maintenance and repair: (Apply directly to the
Inspector: Brian Wert Inspection Agency, 726E
Highway 12,
___2. Construction in a conforming area.
___3. Reconstruction or expansion in a non-conforming area.
___4. A conditionally approved activity.
___5. Variance(s) and conditional uses.
On a separate sheet,
describe in detail the nature of the requests checked above.
Information Required
1. Unless previously waived by the Town
Plan Commission, the applicant shall submit eight copies of all the supporting
documentation required under the Town’s riverway and/or subdivision and road
ordinances. (Provide a completed St.
Croix Riverway Permit Application Checklist.
2. A list of all contiguous landowners
or residents with unsealed, stamped envelopes addressed to these neighbors with
a completed town notification form.
3. Also, provide copies
of all materials, photos, plans and paperwork submitted to the Town to be
mailed (at the applicant’s expense) to the Town Engineer, WiDNR, St. Croix
Cedar
Corporation Rodli, Beskar,
ATTN: Russ Kiviniemi ATTN: Gwen Kuchevar WDNR St. Croix County Planning
Applicant’s Signature: __________________________ Date:__________________________