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LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line -' i .13: 3 Permit Types and Fees:(Please,check appropriate boxes) • n' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,� O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 A <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< 1,Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 or (►- <br /> i <br /> Filling/Grading $150 Boathouse $500 .. v7 II <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. o g. <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c r <br /> NORTH CAMP PROPERTIES V, LLC T 1 �? <br /> Property Owner's Name: a <br /> PO BOX 66 DANBURY WI 54830 <br /> Property Owner's Mailing Address: cn <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 54830 State Zip <br /> Property Site Address: <br /> Contact's Telephone Number: 715-204-4043 d,`- �0 I), a <br /> CD <br /> Contact's Email:: keilee@northcampproperties.com <br /> N <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 0=-.. <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> S <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> u, <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 <br /> Proposed Use of Structure,Addition: (11 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) "3 e3-, <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY —.1.___ <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 eaadditions,and bunkhouses.j�* <br /> ynee�' q�vU a L / 1 LU <br /> dehu,iiwi hAty -ho./ _ Fee Rec:_ <br /> 'lb// / l� Check#: 44 <br /> ii <br /> Date of staff site visit: 1 ! ��l�3 Initial of site vi•I staff: if,- <br /> APPROVED BY LAND SERVICES OFFICIAL: 1/ /pCJ DATE: 5 v <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 1o. �-] <br /> 71> <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT W g E U L <br /> z• .a 0.' m <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 05/2022 <br /> f <br />