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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5� <br /> CD 1 <br /> Permit Types and Fees:(Please,check appropriate boxes) °- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 r, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 09 C) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> -q <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 �� <br /> 1, <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels (Stand a lone 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. ; <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. re; g i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> IMP <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLCa a <br /> IA <br /> PO BOX 66 DANBURY WI 54830 17.Property Owner's Mailing Address: ` <br /> City State Zip < It <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 o K r , <br /> 715-204-4043 t 4 1 t y � d <br /> Contact's Telephone Number: �1 �, '1 <br /> kellee northcamPPro erties.comContact's Email: N -o <br /> a <br /> 0 00 <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 o ', <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND C73 <br /> 7 <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 pefiVit a 3>3,43 <br /> Proposed Use of Structure/Addition: Nett- /tISF sfze-6F 5 t,J(s' E le 4" rkf 517JZ," W v \ 5 <br /> Anticipated Start Date: $- 2 c- z3 (Home/Cabin;Corn '�ercial Business;Bedroom;Deck;etc.) 5,4, '-3 <br /> Building Contractor: 4/ ,J �✓QfG,fS (�M Sewer Installer: <br /> d <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 vpiecoot needs to contact their I D('/n.spector to detern►ine if a per►nit is needed from them prior to <br /> r� <br /> 1.\'Y'construction taking place.for any dwellings, dwelling additions, manufactured homes, manufactured <br /> d <br /> home additions, and bunkhouses."," <br /> CDPICe'J-- 411 se-f-bo <br /> Fee Rec:i`;`15°= <br /> , Check#: 61-42(J <br /> Date of staff site visit:0(/2?`/a3 initials of site vis' staff: PiG rrr, �USfi't rn i 8 <br /> ' --3j <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ii3e�� 4la3cu <br /> a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF °c E.� <br /> 0 CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT " <br /> CD <br /> fD C r,? c <br /> Page 1 of 5 co HT <br /> Burnett County, WI Land Use Application—Rev 05/2022 <br /> CA <br /> "-3 <br /> a <br />