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LAND USE PERMIT APPLICATION — Burnett County, WI ro b <br /> a <br /> < <br /> Applicant Complete All Sections Below This Line <br /> a. <br /> .. '�.. ermit Types and Fees:(Please,check appropriate boxes) p <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 \ , OA <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 41\ a <br /> ., <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 t <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° i ' <br /> r <br /> Driveways/&Campground Structureshe $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500cn C <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 =. <br /> Fa' <br /> • <br /> *NOTE:After-the-fact permits(permit aquired 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. r R i <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Z <br /> 9 <br /> m <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC z IP <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 a <br /> CityState Zip • <br /> < <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 .,• s ,, <br /> a <br /> Contact's Telephone Number: 715-204-4043 ) o <br /> ellee@northcampproperties.com ; �kellee@northcampproperties.com Email: )./...). <br /> N <br /> o a <br /> aho <br /> a <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 v <br /> ,004kction#: 05 Town#: 40 N Range#: 16 W Town of: <br /> OAKLAND p <br /> ttach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> (1-5digit35424 ./� <br /> Tax ID# number; found on tax statement): W o P <br /> x <br /> Proposed Use of Structure/Addition: a e <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 Iv <br /> home a ditions,and bunkhouses.**h <br /> rkee,-1- ali 566tclis <br /> r [ ,4'1lt , Fee Rec: o�j <br /> �v� af J ►I' J f /,Y( Check#: 1702. <br /> i <br /> Date of staff site visit: 1 /;6-3 Initials f site visit taff: r 4' � a <br /> m <br /> r- <br /> s. <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ct/r/v/P....? w r <br /> aifitil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y m E 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o a - FR <br /> —~ '< se ? �; <br /> Page 1 of 5 g Ca-3 tra <br /> Burnett County, WI Land Use Application—Rev 05/2022 < Srn <br /> ����a <br /> a <br /> b <br />