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LAND USE PERMIT APPLICATION —Burnett County, WI t <br /> ,,' F N <br /> Applicant Complete All Sections Below This Line d a N <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $2003 <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 i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> XDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ? 106 Z-- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' VP <br /> Filling/Grading $150 Boathouse $500 '. W io <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. `i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. '" Z <br /> 0 <br /> Z P . <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC g <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 <br /> y E k <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 S Zip o <br /> Contact's Telephone Number: 715-204-4043 E, <br /> g <br /> Contact's Email: kellee@northcampproperties.com <br /> o '° <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 <br /> Section#: OS Town#: 40 N Range#: 16 W Town of: P.. <br /> OAKLAND <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> L <br /> Tax ID#(1-5 digit number; found on tax statement): 354241-3 <br /> y <br /> Proposed Use of Structure/Addition: 6 t:ZZIL 4— boon Ste, Folect.4. C4r(sirE #'g(o t Po <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) H <br /> Building Contractor: Sewer Installer: 'JV <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY `'� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z t-t, <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 20 <br /> 'r— <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured r` <br /> home additions,and bunkhouse ** <br /> 4l��t 4c a. t IUd 4- yl v/t O 8 �G�f$ a��o Fee Rec: <br /> 3 PD rc� v�t,tgf 5c jG ri n-s Check#:1, .Z <br /> �J <br /> o <br /> Date of staff site visit:8/a�1?3 Initials of site staff: (H/ t+ <br /> eg <br /> I C'�7 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 04)Ella 3 i r -� <br /> UPON APPROVAL: APPLICANT MUST POST COPY C <br /> � <br /> OF � �W � C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o ° a <br /> iii c <br /> Page l of 5 <br /> Burnett County,WI Land Use Application—Rev 05/2022 <br /> LL <br /> cn <br /> H <br />