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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> .. <br /> Permit Fees: <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family $200 <br /> Dwelling/Principal Building-Multi-Family $300 Addition to DwellingfPrincipal Building-Multi-Family $200 <br /> n <br /> Commercial/Industrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Ace.Structure $150 Bunkhouse $250 i <br /> Accessory Structure-Commercial CI&11 $200 Addition to Accessory Structure-Commercial C1 &11 $200 t <br /> Deck/Stairs/Patios $125 Gazebo WlStar 59.692(ly)) $350 t <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one yeaz-Only I Allowed $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 application form,see corresponding application and fees. <br /> 21 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. <br /> 0 <br /> Applicant Complete All Sections Below This Line S . <br /> Applicant's Name: Kelly and Julie Ann Orth _ <br /> o � <br /> Applicant's Mailing Address: 15621 Highview DrApple Valley MN 55124 <br /> City State Zip ( y <br /> 3 10 <br /> Applicant's Telephone Number: 952-432-8486 or 952-201-1161 0 <br /> J o 4y <br /> Applicant's Email: kelly.orth@charter.net f <br /> V t <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> b <br /> ❑Letter X Phone X Email ro <br /> 0 <br /> Legal Description: Bass Lake Assessor's Plat Lot 10_(Part of)_CSM map#4621 <br /> Lot#:_I CSM Vol. 25 Pg. 258 OR d <br /> 1 <br /> Lot#:_Prt of 10_Block#: Subdivision Name: Bass Lake Assessor's Plat OR <br /> Gov't Lot#: OR 1/4 1/4 ::; 0 <br /> Section#: 13 Town#: 41 N Range#:_16 W Town of: Swiss <br /> f <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24digits):07-032-2-41-16-13-5 15-044-020000 1 <br /> 1 <br /> Tax ID#(1-5 digits): 32806 Z Sc/ <br /> Property Site Address#:_30932 H <br /> Road Name: Tower Rd City:_Danbury <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec:�n(�, <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> X Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure <br /> ❑ Permit Extension ❑ Gazebo—WI Stat 59.692(ly) ❑ Camping Unit ❑ Commercial Acc. Addition C ��t <br /> Proposed Structure/Addition Use: Home/Cabin N Z u u <br /> (Home/Cabin:Commercial Business:Bedroom:Deck;etc.) O m <br /> Building Contractor: Z ,la <br /> G)0 N <br /> Anticipated Start Date: 4/15/2016 C o <br /> Page 1 of 4 <br /> Burnett County,WI Land Use Application—Rev 4/2015 C� <br />