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r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a 1 " <br /> A plicant Complete All Sections Below This Line a F it b <br /> a <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 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 c <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 o <br /> nluneGr„4in 515n a02.thouse. $500 I� <br /> Solar Panels(Stand alone or roof mounted) $15D 'Permit Extension(1 Year Extension-Allowed Once) ,$100 S. <br /> Al <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. o <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> 0 <br /> NORTH CAMP PROPERTIES V, LLC Jm <br /> t <br /> Property Owner's Name: o <br /> FT in <br /> Property Owner's Mailing Address: <br /> PO BOX 66 DANBURY WI 54830 <br /> City C State Zip <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830v c <br /> Contact's Telephone Number: 715-204-4043 i,-,-e Li J d <br /> Contact's Email: kellee@northcampproperties.com <br /> N b <br /> Legal Description of Property: Lot 1 C5tv1 494b V2 ti-,3015 LUC461 bb8 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: <br /> OAKLAND O <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 ;.....90 <br /> iii <br /> Proposed Use of Structure/Addition: W g d <br /> Anticipated Start Datc: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) .-3 6 e .) <br /> Building Contractor: Sewer Installer: I Ch <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 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 ditions,hand bunkhouses ** �,� <br /> Vr►> C 0. �[C Ike , <br /> S- -fir b- �� I _, --Fee Rec: jo.2 <br /> e Check#: 6,L 0 Li/ <br /> • <br /> a <br /> Date of staff site visit:9 1Initi is of site sit staff: ()-1G 4 w ' r- <br /> a <br /> z <br /> . • f <br /> 1I a/?3 a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: x <br /> n <br /> UPON APPROVAL: APPLICAN I MUST POST COPY Or rMI <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <3 -v 0 <br /> r- CD c� inn <br /> CD a UuL <br /> c) W <br /> Page l of 5 . a c r.z <br /> Burnett County,WI Land Use Application—Rev 05/2022 { `< ; . v'�-,n, <br /> o Ind <br /> K <br /> -fl <br />