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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5' K <br /> Permit Types and Fees:(Please,check appropriate boxes) ua <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 OQ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,..1) O <br /> •Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> 11(1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 , 21 <br /> `� (Deck/Sta <br /> irs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ).1 <br /> Filling/Grading $150 Boathouse $500 Wok <br /> ;Solar Panels(Stand alone or roof mounted) $150 _ Permit Extension(1 Year Extension-Allowed Once) $100 a <br /> 1% <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. 5' <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> NORTH CAMP PROPERTIES V, LLC o l <br /> Property Owner's Name: a <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 .ET 011 <br /> ' ��, ,t <br /> CityState Zip if, <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 o c <br /> ii � <br /> Contact's Telephone Number: 715-204-4043 `A ' o <br /> Contact's Email: kellee@northcampproperties.com <br /> A tk t 119 rp <br /> a <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558cro <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 /> a, <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 c H <br /> Proposed Use of Structure/Addition: W o o <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -3 VIJ <br /> Building Contractor: Sewer Installer: c <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 bunkhouses.** <br /> a Nc4- &or hv.two mob. 14)1 `x <br /> Fee Rec: <br /> Check#: e4C-14*--,' <br /> Date of staff site visit: 91 at 1 a3 u 6 Initials of site visi taff: r l r7 Rtvki P6R4.c. <br /> APPROVED BY LAND SERVICES OFFICIAL: • <br /> • <br /> DATE: q 1??),?-3rr <br /> 7 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o } <br /> z <br /> . E-E <br /> 0 - u) <br /> Page 1of5 _ > C0-0 <br /> Burnett County, WI Land Use Application—Rev 05/2022as <br /> 0 <br /> (tn <br /> 1 <br /> b <br />