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• <br /> LAND USE PERMIT APPLICATION —Burnett County,WI 0 <br /> Applicant Complete All Sections Below This Line SR? <br /> ro <br /> G. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Prtncipal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 m <br /> Commercial/Industrial Structure $300Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 . Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 el <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ;, Z <br /> X Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° N (), <br /> Filling/Grading $150 Boathouse $500 r N <br /> Six Month Camping Unit(One Per Year) $100, Permit Extension(1 Year Extension-Allowed Once) $100 <br /> u3 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. g <br /> 'Communication Towers&Signs require a different application form;see corresponding application,and fees. ,$ <br /> Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> g <br /> Property Owner's Name:North Camp Properties II LLC DBA Lazy Bear Campground ' o <br /> Danbury WI 54830 I"' <br /> Property Owner's Mailing Address: PO BOX 66 g r <br /> City State Zip - r <br /> Property Site Address:28281 County Roc — Webster WI 54830 iin <br /> Contact's Telephone Number:715-204-4043 15� a H <br /> 4 <br /> , Contact's Email:kellee@northcamporoperties.com V. <br /> Legal Description of Property: <br /> Lot 1 CSM#2195 v.12 pg 203 NE1/4af the NE1/4&SE1/4 of the NE1/4 " I <br /> Section#:21 Town#:40 N Range#:15 W Town of:Jackson 0 "° <br /> OQ ilk &".. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> 11Tax ID#(1-5 digit number;found on tax statement):5448 o' ..-. r <br /> 1" IF• <br /> Proposed Use ofStructure/Addition: 5 4-e,Q3 A-0 R v i <br /> Anticipated Start Date: -Z(;, 2 _ (Home/Cabin,abin;Commercial Business;Bedroom:Deck:etc.) '4; ) N c <br /> Building Contractor: Sewer Installer: LA.) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW; c. C ...-t <br /> ,*Ilu appliu:aot needs to control their IIDC Inspector to detertnitte if ti permit is needed front them!War lo 0 <br /> •t:N'I'<'totVIM tion taAing pilaw(Or any du' llin,s,tlwt,ling additions,nrrrtttenclurcd Ironies,trtattufat.tortd Z <br /> home additions,and Fatal;houses.* 700 <br /> F <br /> Fee Rec: /arj CD <br /> - <br /> 5i <br /> Check#:3r51/ <br /> rn <br /> Date of staff site visit:0101912-d initial of site vii a d L. r. <br /> APPROVED BY LAND SERVICES OFFICIAL: I,. /�./j/ DATE: !//A2d < <br /> J D <br /> UPON APPROVAL: APPLICAr. MUST POST COPY OF 7E� � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -,, <br /> IGHTo 7. <0 0 <br /> Iffi <br /> Transcendent: Page 1 of 4 `D m <br /> Burnett County,WI Land Use Application—Rev 12/2020 -8 S ry o <br /> Laserfische: Co <br /> 3 N <br /> Y 7 OW <br />