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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> h m jr <br /> Permit Fees: <br /> Dwelling/Principal Building-Single Family $300 Addition to DwellingtPrincipal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family $200 <br /> Commercial/tndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Bunkhouse $250 1 <br /> Accessory Structure-Commercial CI&Il $200 Addition to Accessory Structure-Commercial Cl&tl $200 <br /> Deck/Stairs/Patios $125 Gazebo I Stat 59.692 lv $350 gn <br /> Camping Unit $100 Fillin Gradin $150 <br /> Permit Extension Valid for one year-Only 1 Allowed $100 <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. v <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> *1tems not listed above will be treated as accessory structures,such as: pergolas, landscaping,retaining walls. L_ <br /> ro <br /> Applicant Complete All Sections Below This Li* � �• <br /> z <br /> 0 <br /> Applicant's Name: Glen Anderson <br /> Applicant's Mailing Address:_1930 Knox Ave S Minneapolis MN 55403 <br /> City State Zip ro <br /> Applicant's Telephone Number: o e <br /> a <br /> Applicant's Email: drrockmpls@aol.com d <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. SU <br /> ro <br /> ❑Letter ❑Phone xEmail o <br /> 0 <br /> Legal Description:—Lot 3 CSM V 2 P 49 and Pcl Desc 415/386 w <br /> t <br /> Lot#: 3 CSM Vol. 2 Pg. <br /> _49 OR C <br /> Lot#: Block#: Subdivision Name: OR = v, <br /> Gov't Lot#:_2 OR 1/4 1/4J03 <br /> Section#:_36 Town#: 40 N Range#:_15 W Town of_Jackson <br /> *Attach additional page if neededjor lengthy description OR attach a copy of the deed OR attach tax system propertyPage. <br /> t <br /> Parcel#(24 digits):_07-012-240-15-36-5 05-002-016000 <br /> Tax ID#(1-5 digits): 6088 <br /> Property Site Address#:_27607 I �S <br /> Road Name: Thompson Bay Rd _City: Webster N I <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:ly0 <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> H <br /> ❑ Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs X Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Aa.Structure m <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition zC <br /> n <br /> .11 <br /> Proposed Structure/Addition Use: Storage shed <br /> (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) M <br /> Building Contractor: Northland Builders Inc _—it � <br /> d t� <br /> C=) <br /> Anticipated Start Date: 10/1/2015 m C <br /> Page 1 4 0 <br /> Burnett County,WI Land Use Application—Rev 4/2015 � C� <br /> T <br />