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b <br /> LAND USE PERMIT APPLICATION — Burnett County, WI 2 <br /> Applicant Complete All Sections Below This Line a <br /> _ <br /> Permit Types and Fees:(Please,check appropriate boxes) y . <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 rp <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 <br /> P <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n I'Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> 2 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 t <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension .Allowed Once) $100 z <br /> w <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. C C <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. or g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> , <br /> Property Owner's Name: a.NORTH CAMP PROPERTIES V, LLC 0 0 <br /> PO BOX 66 DANBURY WI 54830 E. n <br /> Property Owner's Mailing Address: cn <br /> cn <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 54830 State Zip0 i1' <br /> Property Site Address: . ro <br /> Contact's Telephone Number: 715-204-4043 , 3 J o <br /> Contact's Email: kellee@northcampproperties.com N <br /> o CIO <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 <br /> 05 40 N Range#: 16 W Town of: OAKLAND u. <br /> Section#: Town#: g <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 F y <br /> DProposed Use of Structure/Addition: eGk, CA,P) V <br /> Anticipated Start Date: ''// AA (Ho :e/Cabin:Commercial Business;Bedroom:Deck:etc.) `R <br /> lq. V <br /> Building Contractor: U/4 Sewer Installer: J/'`A <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0 r--- <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 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhnu•es.** <br /> p-"ee4- et1I <br /> ®NA r I <br /> j- Q 1y141 A ,Tb71 Fee Rec:02 <br /> Check#:[t( kt <br /> ti <br /> Date of staff site visits /?? /2.3 Initial of site isit staff: ��t" <br /> a <br /> 91a1/10 z <br /> c <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: a o <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y 3 <br /> fa <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 6 fin, W -T <br /> Z <.3 L <br /> J CD ti ---. Y Y <br /> Page 1 of 5 o e� <br /> Burnett County, WI Land Use Application—Rev 05/2022 n „9 r3 <br /> o g ;.atn CD J l t1 <br /> b <br /> J <br />