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ro <br /> LAND USE PERMIT APPLICATION —Burnett County,WI E <br /> 1 <br /> - Applicant Complete All Sections Below This Line o• <br /> Permit Types and Fees:(Please,check appropriate boxes) a (n <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v v1 <br /> Commercial/Industrial Structure $300 Addition/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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 r;-..., <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' <br /> ink <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 aquired after construction has begun)may cost up to three times the normal fee. v <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. og 11 <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c re <br /> • <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC g <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 ,r" <br /> ty E <br /> Property Site Address: <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 548C30 State Zip c <br /> Z. W C\ <br /> Contact's Telephone Number: 715-204-4043 LO�� Y0 'V3 <br /> Contact's Email: kellee@northcampproperties.com N y <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 1• (�� <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAIQAND 5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 1_14y c <br /> A. <br /> Proposed Use of Structure/Addition: K. �r 11.3 <br /> iik C <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) V_ y <br /> Building Contractor: Sewer Installer: IF— V:z. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> TILLS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z �' <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 'a <br /> ANY constructi in taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and b nkhou ** <br /> rj <br /> I) M-ref all s L .L _ <br /> ®AA4 11,0144 )ii Uil.' c, Fee Rec#/as <br /> se <br /> y Check#: 9 y45- <br /> Date of staff site visit: g 1t71�3 Initials f site visit ff: //� tz r -- <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 9/if/13 y` <br /> z. 1711 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ';_W <br /> 1, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT }- <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 05/2022 ' <br /> y <br /> yyH <br /> t'� <br />