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LAND USE PERMIT APPLICATION—Burnett County W-I <br /> Applicant Complete All Sections Below This Line Fa <br /> j � J <br /> Permit Types and Fees:(Check appropriate box1boxes) 5 <br /> E <br /> D„elling(Principal Building-Single Famih 5300 Addition to D,wlling/Principal Building-Single Family 5200 c <br /> Ds elling(Principal Building-Multi-Family 5300 Structural Alteration to Dwelling/Principal Buildings $200 <br /> CommerciaUlndustrial Building 5300 Addition to Commercialfindustrial Building 5200 \^ 1 <br /> Accessory Structure(Non-Bunkhouse) 5150 Addition to Accessory Structure 5150 <br /> Bunkhouse 5250 Structural Alteration to Accessory 515 <br /> Structure 0 < <br /> unC._1z �y..� <br /> Accessory Structure-Commercial(Cl &11) 5200 Addition to Accessory Structure-Commercial(Cl &11) 5200 <br /> 4 <br /> Deck/Slairs(Patio/Retaining WalMde%alk/Driveway& Gazebo(WI Stat 59.692(lv)) 5350 <br /> Campground Structures - <br /> 5125 1 Filling/Grading VSO <br /> Camping Unit(Six Months Per Year) SIOU Boathouse $500 •� <br /> Permit Extension(Valid for one)ear-Only I Allowed) 5100 <br /> z <br /> "NOTE After-the-fact(when no permit is obtained prior to construction)is up to three times the normal fee. _ <br /> *Communication Tourers&Signs require a different application form,see corresponding application and fees. <br /> •/nems not listed above will be treated as accessory structures,such as.pergolas.landsco in .etc. - <br /> Property Owner's Name: Jeffery and Jennifer Stanek <br /> Property Owner's Mailing Address:_ 2412 123d Circle NW Coon Rapids, MN 55448 4 € g <br /> City State Zip <br /> Property Site Address: 8319 Greentree Trail Danbury WI <br /> Contact's Telephone Number: 763-807-4374 N — <br /> Contact's Email:_jeffstanek@nidamarketing.com <br /> Legal Description of Property: Lot 2 CSM V 19 P252 <br /> Section#:_13 Town#:_40 N Range#:_l7 W Town of:_Union L ^ <br /> ".4ttach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement):-24712 <br /> Proposed Use of Structure/Addition: House <br /> Anticipated Start Date: 7/12/201_7 (Home-Cabin:Commercial Business:Bedroom:Deck.etc./ <br /> Building Contractor; <br /> _Northland Builders Inc Sewer Installer:_Hopkins Sand and Gravel z d <br /> AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY z d <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: . <br /> Fee Recce <br /> GV-� <br /> Date of staff site visit: —) I I Iniials of site visit staff: - j C7 <br /> 0I I�+ <br /> r— <br /> PERMIT APPROVED BY ZONING OFFICIAL. - DATE: y f I ' _ CD <br /> cj <br /> Page I of 3 <br /> Burnett County, 'I Land Use Application—Rev 03/2017 <br />