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LAND USE PERMIT APPLICATION — Burnett County, WI a 5 ro <br /> Applicant Complete All Sections Below This Line 5 `3 <br /> Permit Types and Fees:(Please,check appropriate boxes) o. <br /> P by <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 U <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c V V <br /> Filling/Grading $150 Boathouse $500cp I <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 R. <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. . )• <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o r <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC m. <br /> �`� <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 MP <br /> CityState Zip o w <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 Fa <br /> Q. <br /> Contact's Telephone Number: 715-204-4043 1.-Of <br /> ,,f / o <br /> Contact's Email: kellee@northcampproperties.com <br /> N -o <br /> o no <br /> 0. <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> a. <br /> 9 <br /> *Attac•h additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): 35424 o <br /> Proposed Use of Structure Addition: 4 V <br /> Anticipated Start Date: (Home/Capin;Commercial Business;Bedroom;;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 4+ ` <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 my dwellings,dwelling additions,manufactured homes,manufactured <br /> • home additions,and bunkhou es.** <br /> Meek all Sees <br /> is <br /> 0No4- "Y%( 'ow tw4 bi4m4 D"1 Fee Rec: I,t <br /> Check#:(0 -2 <br /> Date of staff site visit: 1q 1?I l/ J�' 3 Initials f site vis' staff: ` h <br /> c <br /> 7. <br /> APPROVED BY LAND SERVICES OFFICIA DATE: F <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ( E <br /> g.SIGNED PERMIT APPLICATION IN PLAIN SIGHT z1 Page 1 of 5 T Burnett County,WI Land Use Application—Rev 05/2022 5,T.V J> <br /> - <br />