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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> • b <br /> Applicant Complete All Sections Below This Line 0' N <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> c7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ° I`� <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 \ i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> 'Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ) t -C Filling/Grading l'g g $150 Boathouse $500 UJ 1:1' <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 7 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. •0 <br /> CD I <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> I. �r <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC g <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 = �� <br /> City State Zip < <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 'S o <br /> p 715-204-4043 n <br /> Contact's Telephone Number: ct- .• C i -7 J, 'y <br /> Contact's Email: kellee@northcampproperties.com <br /> N '0 <br /> 0 MI <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 v <br /> q e <br /> Section#: 05 Town#: 40 N Range#: 16 _W Town of: OAKLAND <br /> IS— <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> v) <br /> Tax ID#(1-5 digit number; found on tax statement): 35424 (C) o w <br /> Proposed Use of Structure/Addition: � 1 .'� ( _ o <br /> Anticipated Start Date: (Home/Cabin;Commercia Busine.s;Bedroom;Deck;etc.) V� H <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> "C <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 bunkho es.** <br /> rF" 4� O( / y Fee Rec:g 4 Iv ix teitie ve� 7111 1 -f- �( N Check#: / 9li <br /> Date of staff site visit: 9/?I / Initials f site vi 't staff: J-I!/ kr m <br /> r <br /> a <br /> o J <br /> APPROVED BY LAND SERVICES OFFICIAL _DATE:__ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Inn/ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT oz _ ��1��� <br /> N �J �+U <br /> as <br /> 7 Co Q <br /> sz, <br /> Page 1 of 5 tr v r\ <br /> Burnett County, WI Land Use Application —Rev 05/2022 <a m <br /> m <br /> L.. J <br /> K <br />