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LAND USE PERMIT APPLICATION— Burnett County, WI L <br /> s '. - <br /> Applicant Complete All Sections Below This Line 4. gt t <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 e <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CFI d <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 o <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ' <br /> *NOTE:After-the-fact permits(permit aqui red 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. c g -� <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. „ <br /> IO <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC —�f <br /> 0. <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 y• <br /> Cit State Zip <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830v • <br /> 0 G <br /> Contact's Telephone Number: 715-204-4043 �� . ) C7 <br /> l C <br /> 1 S <br /> Contact's Email: kellee@northcampproperties.com <br /> e <br /> 8 <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 tic <br /> 5 <br /> CM <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> 5. <br /> *AttachZS- <br /> 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 1'4 c <br /> WC k <br /> Proposed Use of Structure/Addition: (J' ° e <br /> Anticipated Start Date: (Home/Cahin:Commercial Businetc;Bedroom;Deck;etc.) .--3 lbW <br /> oh <br /> f h <br /> Building Contractor: Sewer Installer: V' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ‘ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 7, <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 k...7.- <br /> home additions,and burnLkhou-es.** <br /> . Nod%r fl.~ ha f 11146 Fee Rec. ah <br /> Check#:-- • <br /> tA <br /> 1 a <br /> Qr <br /> Date of staff site visit: `+21�17�3 Initials f site visi aff: HE A 7' <br /> a <br /> z <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: WS/23 v <br /> < 1-- �1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ci a iffil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 2 m m <br /> Page l of ea <br /> >_t <br /> Burnett County,WI Land Use Application -Rev 05/2022 < 1 1 <br /> r <br /> i <br />