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LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line ° ` As14.11O•W <br /> Permit Types and Fees:(Please,check appropriate boxes) n. <br /> C7 <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 /> 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 rAccessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,Z <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350r�. <br /> o ..,g <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> r, <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. r g. i <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c <br /> NORTH CAMP PROPERTIES V, LLC a Q.)Property Owner's Name: c, v' <br /> 9_ 1 <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 t` <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830ry State Zip c Ur <br /> ft <br /> p 715-204-4043 1 ' b? o 'c <br /> Contact's Telephone Number: l p <br /> Contact's Email: kellee@northcampproperties.com <br /> "0 <br /> o av <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 4 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND tiq <br /> 5. <br /> n <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 vk <br /> ii IkProposed Use of Structu e/Addition: :: ti <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) J <br /> Building Contractor: Sewer Installer: r • <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z - <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <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 c� <br /> home additions,and bunkho ses.** r <br /> n cep col s.e <br /> g <br /> ivd4— ,c,ji- Itiouil AA, .74tC)A Fee Rec: — <br /> Check#: 6- h <br /> 1 I a-I /a_3 Initials f site visit aff: , I v -f let i <br /> Date of staff site visit: r� r <br /> q <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: lo`5 I? 3 y ci <br /> ' r- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF WE_:-: <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 <br /> c• o tom.. <br /> r <br /> Page 1 of 5 CD c "a,-v i:.,,: <br /> Burnett County,WI Land Use Application —Rev 05/2022 • - `..." <br /> 1 <br />