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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5J <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 . <br /> j( Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< ' <br /> A Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r ii•- <br /> Filling/Grading $150 Boathouse $500 <br /> to <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 .1. lk <br /> II <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. '0 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c A <br /> p NORTH CAMP PROPERTIES V, LLC ° <br /> Property Owner's Name: a <br /> Property Owner's MailingAddress: PO BOX 66 DANBURY WI 54830 w' n '11,1 <br /> p rtY <br /> CityState Zip <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 ... o <br /> Contact's Telephone Number: 715-204-4043 6,-+ "- l (- d <br /> Ni <br /> co <br /> Contact's Email: kellee@northcampproperties.com N <br /> O on <br /> m <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 v <br /> F. <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <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 c <br /> Proposed Use of Structure/Addition: d <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) "-3 Q <br /> Building Contractor: Sewer Installer: <br /> Q <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 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions, and hunk!: uses.** <br /> aNQl ii“in 44 ita t-4?dO1' Fee Rec:/(25 <br /> Check#: L, i <br /> Date of staff site visit: —)[]'21 lt_ Initi is of site visit staff: I � 1 <br /> 5�1�j S koi-iNvr <br /> APPROVED BY LAND SERVICES OFFICIAL: M DATE: I hall?3 ___, ______)j, <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF , CC) ¢. <br /> C`�I <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �.a -�-° <br /> o r <br /> Page 1 of 5 ! <br /> Burnett County, WI Land Use Application—Rev 05/2022 f.,'.) ( ! <br /> H Ii <br /> R7 <br /> I <br />