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LAND USE PERMIT APPLICATION -Burnett County, WI E <br /> i b <br /> r,. <br /> Applicant Complete All Sections Below This Line n' <br /> 2. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .% <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 04 <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 ek ` , cc <br /> &Campground Structures $125 WI State Statute 59.692(1v)Structures $350 - \N`, 1t•• <br /> Filling/Grading $150 Boathouse $500 .. y 0 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> i <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <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. c <br /> Property Owner's Name: <br /> NORTH CAMP PROPERTIES V, LLC $ "— I <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 <br /> 1 <br /> �y '. <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830CState Zip o <br /> Contact's Telephone Number: <br /> 715-204-4043 L -0" b d <br /> Contact's Email: kellee@northcampproperties.com .. <br /> o r <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 1. <br /> 1 , <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND 5' �o{ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> a <br /> Tax ID#(1-5 digit number;found on tax s tement : 3 24 � O V <br /> Proposed Use of Structure/Addition:De + Sn VJ 01 �d` ` <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) "3 w <br /> Tl <br /> Building Contractor: Sewer Installer: <br /> 4) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY — ._ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to xi <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,an bun hou es. <br /> :16 <br /> i M e-e�- a e- <br /> N M d, -hon <br /> a St� t'� Tom! �'�' Fee Rec: 1a5 <br /> y Check#: <br /> Date of staff site visit:8l P-d'/a 3 Initials 'f site vis' staff: (-iL✓ <br /> APPROVED BY LAND SERVICES OFFICIAL: ti DATE: ! 3 0 —�� <br /> so <br /> N <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF @ n <br /> .3 Ci vL< <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o y Cl O J E <br /> Page 1 of 5 c) r t.--,,z. <br /> Burnett County,WI Land Use Application—Rev 05/2022 51 , , <br /> y LL J� <br />