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LAND USE PERMIT APPLICATION — Burnett County, WI a 2 <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 co <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 n <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 8 <br /> Driveways/&Campground Structures 5 WI State Statute 59.692(1v)Structures $350 R �' <br /> Filling/Grading $150 Boathouse $500 P <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ;° <br /> r <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r . <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o7. v <br /> m V <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC a <br /> W v , <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 — CA <br /> City State Zip S <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 _ <br /> Contact's Telephone Number: 715-204-4043 t i`k.--tt 12. 2. <br /> 2. <br /> Contact's Email: kellee@northcampproperties.com (� <br /> N <br /> o ao <br /> a <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558IQ <br /> Section #: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> 7-7 <br /> *Attach additional page if needed jar lengthy description OR attach a copy of the deed OR attach tax si,stem property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): 35424 o, ,. x <br /> Proposed Use of Structure/ ditipn: peak (77,..tier) U\ ' d <br /> Anticipated Start Date: 'ii O 31 (Home.'Cabin:Commercial Business:Bedroom;Deck;etc.) <br /> Building Contractor: SG/-0 Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY •- ..- <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z oLs, <br /> 'The applicant needs to contact their CDC Inspector to determine if a permit is needed from them prior to <br /> :'1.`.Y construction taking place fin.any drrellitiArs, dwelling additions, manufactured homes, nranufac•ttn•ed ,� <br /> home additions, and bunkhouses.** <br /> 6)i i GG-4- a l( 5e4-} .c 1 <br /> Fee Rec: /.2 61'2 <br /> Check#: C <br /> Date of staff site visit: )D5/-.)-3 Initial of site vi 't staff: PE <br /> > <br /> �1/ac�a3 v r=� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: a � _�. <br /> < r— <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a nff <br /> H Fe tp -v C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m <br /> z Co 0o <br /> � ` v.,Page 1 of 5 n w <br /> Burnett County,WI Land Use Application—Rev 05/2022 g ((—jj <br /> T a <br /> J <br />