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LAND USE PERMIT APPLICATION —Burnett County, WI 4 <br /> Applicant Complete All Sections Below This Line ° E ' V. <br /> co <br /> Permit Types and Fees:(Please,check appropriate boxes) t7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 \� o <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150Ci 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G-7 r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< , <br /> Driveways/&Ca mpground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 II <br /> vi <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. I <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. c 9, v <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. c 1 <br /> . NI <br /> 111, <br /> LLC CAMP PROPERTIES V NORTH , o <br /> Property Owner's Name: B- — v <br /> a. <br /> PO BOX 66 DANBURY WI 54830 °'• n <br /> Property Owner's Mailing Address: '' <br /> Property Site Address: <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 54830 State Zip <br /> Contact's Telephone Number: 715-204-4043 1 d <br /> �, <br /> Contact's Email: kellee@nolthcamppropertles.com <br /> N -i <br /> o uv <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 5. <br /> Section#: 05 Town#: 40 N Range II: 16 W Town of: OAKLAND <br /> 5. <br /> ci <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 7, x <br /> Proposed Use of Structure/Addition: Lc L,k 0,I 's(' td_` <br /> Anticipated Start Date: .l 1( Q c•1C� J kJ..-(\ 1 c (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) j w <br /> Building Contractor: v e 1 Sewer Installer: — <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY O QJ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I —Z—. <br /> I <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 bunkhpp ses.** <br /> 0mGe4' al( Se back 04 <br /> Fee Rec: ur c <br /> 7, Check#: (paw <br /> NI/J,r 4 Date of staff site visit: / 123 Initial of site visit staff: 1l L' 'r m <br /> r <br /> • (' I <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: I I?5 23 !.r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ca ct F (����f7[,` <br /> 1 V <br /> g, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Fa <br /> .N 0 ' <br /> ...I. O o <br /> Page 1 of 5 �' <br /> Burnett County,WI Land Use Application—Rev 05/2022 rffil <br />