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LAND USE PERMIT APPLICATION — Burnett County WI 7" <br /> Permit Fees: 5 <br /> � � E <br /> Dwelling/Principal Building-Single Familv 5300 Addition to Dsvellin Princi al Buildin -�ily $200 <br /> D«ellin Princi al Building-Multi-Familv $300 Addition to Dwellin Princi al Buildin -Multi-Family $200 <br /> P <br /> Commercial/Industrial Building 5300 Addition to Commercial/Industrial Building $200 ' r, <br /> Accessory Structure/Addition to Ace.Structure <br /> $150 Bunkhouse $250 � 1 <br /> Accessop Structure-Commercial(Cl & 11) $200 Addition to Accessory Structure-Commercial(CI &11) $200 1 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.692ly ) $3.50 1 <br /> Camping Unit $100 Filling/Grading Filling/Grading $Iso <br /> Permit Extension(Valid for one vear-Only I Alloy+rod) $100 ' <br /> `NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. <br /> "Communication Towers&Signs require a different applicalion dorm,,see corresponding application and fees. <br /> "Items not listed above will he treated as accessory structures.such as. pergolas, landscaping, retaining walls. <br /> Applicant Complete All Sections Below This Line <br /> Applicant's Name:__Er1'c Tanquist <br /> 0 <br /> Applicant's Mailing Address:_404 Woodland Dr Burnsville MN 55337____ <br /> City State Zip y <br /> Applicant's Telephone Number: '-I$ Z <br /> Applicant's Email: tanquist@hotmail.com <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> []Letter [&Phone ❑Email <br /> Legal Description:_____ �. <br /> 00 I <br /> Lot#:__6___CSM Vol._6_ Pg._334 OR Q <br /> Lot#: Block#: Subdivision Name: OR A <br /> to <br /> Gov't Lot#:_5_OR 1/4_ 1/4 J o <br /> Section#:_24 Town#:_40 N Range#:_15 W Town oF._ Jackson I } <br /> ",attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system properly page.' <br /> Parcel #(24 digits):_07-012-2-40-15-24-5 05-005-014000 `} <br /> Tax ID#(1-5 digits):__5595 n z <br /> II <br /> Property Site Address#:_28175 — <br /> Road Name:-,——Bonner Lake----,--- _ City:_Webster I <br /> E <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec <br /> LJ Single by <br /> Single Family Dwelling ❑ Multi-Family Dwelling J Filling/Grading LJ Commercial Building s <br /> X Single Family Addition ❑ Multi-Family Addition J Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure C <br /> ❑ Permit Extension ❑ Gazebo-WI Stat 59.692(iv) ❑ Camping Unit ❑ Commercial Acc. Addition _ D <br /> 6Nm <br /> Proposed Structure/Addition Use:_Addition to cabin home _ VZ <br /> (Nome:Tahin:Commercial Business:Bedroom:Deck:etc.) <br /> zo <br /> Building Contractor:__Northland Builders Inq �G) Q o_ <br /> -- rn <br /> Anticipated Start Date:_5/2/2016_ Z <br /> Page 1 of 4 El <br /> Burnett County, WI Land Use Application— Rev 4/2015 4 <br /> T <br />