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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5i <br /> CD I <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) F <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $2000 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 G <br /> 2. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> XDriveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 k) <br /> Filling/Grading $150 Boathouse $500 — <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 = <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. ro :, <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o 1 i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> ° <br /> M <br /> NORTH CAMP PROPERTIES V, LLC I <br /> • <br /> TS <br /> Property Owner's Name: F <br /> PO BOX 66 DANBURY WI 54830 . en <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 5483 c G <br /> Contact's Telephone Number: 715-204-4043 c i- - 40J d <br /> Contact's Email: kellee@northcampproperties.com ., <br /> N -o <br /> o no <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 a W <br /> CI 0 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> cn <br /> Tax ID#(1-5 digit number;found on tax`statement): 35424 - ,-3Proposed Use of Structure/Addition:nA 0\c ,Vi or (0-C- 6/ i t><6" 54tf K- P .� `iS4-11-a dec1 e 3 e <br /> Anticipated Start Date: /- 9- 2 0 22 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (J W H <br /> flo W <br /> Building Contractor: L o4 L e 5 5'e f Sewer Installer: A <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Q " <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z A �N <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to T <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes, manufactured <br /> home additions,and bunkhouses.** <br /> Fee Rec: I <br /> Check#:/v‘c,e4 <br /> 6 2.2-O077270.0 5- <br /> Date of staff site visit: Initials of site visit staff: /17:- <br /> ...i. 3 <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: , DATE: O7i%o 2.-Z ri ' r <br /> Jc.2) <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF " ; ffil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o CD 3 <br /> r" mw *N.:, NB <br /> N 0 00 <br /> Page 1 of 5 E» m g N Q <br /> Burnett County,WI Land Use Application—Rev 05/2022 i 12 K iv <br /> ) <br />