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LAND USE PERMIT APPLICATION —Burnett County, WI <br /> Applicant Complete All Sections Below This Line `$• id3 <br /> Permit Types and Fees:(Please,check appropriate boxes) o b <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 I. <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 $15011 co <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n (, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 4. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o ` <br /> Filling/Grading $150 Boathouse $500 ci, <br /> w <br /> Permit Extension(1Year Extension-Allowed Once) $100 ' <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 1 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o i• <br /> I <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o lib <br /> -n <br /> Property Owner's Name: North Camp Properties V, LLC DBA DuFours Campground <br /> a. 1110 <br /> Property Owner's Mailing Address: PO Box 66 Danbury WI 54830 14, <br /> ,....-,,1 City State Zip o ET % ' <br /> Property Site Address: 29221 Hayden Lake Road Camp Site#: - <br /> Contact's Telephone Number: 715-2044'043 -,,,a <br /> Contact's Email: Ni ii <br /> kellee@northcampproperties.com N <br /> 0 w <br /> Legal Description of Property: Lot 1 CSM 4945 V27 P306 ag0 <br /> w <br /> Section#: 6 Town#: 40 N Range#: 16 W Town of: Oakland q. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 Cn '0"'( <br /> Proposed Use of Structure/Addition: v 1 d <br /> W <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY --r — <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> 7 <br /> /he_ A- all Se 'bc csws <br /> sId ;$ ✓l--'- rf-o/ hkot-an ha 1'1!'c1/ 4 1.2'5`3- <br /> y Fee Rec: <br /> x <br /> y Check#: T((� <br /> b <br /> M <br /> Date of staff site visit: k/t?-3 Initials site visit staff: N <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 5/19/a,3 J <br /> m a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF F n 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CI 0 <br /> N Iffii <br /> o <br /> Page 1of5 = 3 w <br /> Burnett County,WI Land Use Application —Rev 12/2021 . _ -- 1 J <br /> �'J <br />