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LAND USE PERMIT APPLICATION-Burnett County, WI Cl) r <br /> b <br /> Applicant Complete All Sections Below This Line g c N <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 -I) O <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 /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c O Isi <br /> Filling/Grading $150 Boathouse $500 ��NNN <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 `i <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ti- <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r g. <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> 0 <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC a I <br /> Property Owner's Mailing Address: <br /> PO BOX 66 DANBURY WI 54830 ,` <br /> City State Zip C I'� <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 o G <br /> 0. <br /> Contact's Telephone Number: 715-204-4043 <br /> Contact's Email: kellee@northcampproperties.com <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 ' <br /> C7 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> 72. <br /> 52. <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 Q o <br /> Proposed Use of Structure/Addition: ki( t7 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;;Bedroom;Deck;etc.) .-1 V) <br /> Building Contractor: Sewer Installer: 0 <br /> Q "..Z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY qJ <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,and bunkhouse-.** r <br /> 0 >meCA- all 5 it <br /> S W�j(, , Fee Rec: <br /> /LI,,�L be Ch jG�54 !S��i 0��( 4(r 5Gl Ct✓Z 0 Check#: L0173.7 <br /> Date of staff site visit: I /a-' /�;3� Initial of site vi 't staff: ilF -t k <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 1 r?)/23 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Ti w W > (f [�I(J <br /> CZ <br /> 72. z.3 cv) <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT - y rini <br /> Do - o <br /> � � 2 <br /> r`9 <br /> Page 1 of 5 A 0 " <br /> r_1 <br /> Burnett County,WI Land Use Application—Rev 05/2022 < CD <br /> ° ~ L -J <br />