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LAND USE PERMIT APPLICATION — Burnett County, WI C" <br /> a <br /> Applicant Complete All Sections Below This Line g. E -K W <br /> Permit Types and Fees:(Please,check appropriate boxes) A Fy°" <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> V Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 Z <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o w CJ <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 `_ h <br /> m <br /> q <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. n ; <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. or <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ,, <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC F r <br /> o. <br /> PO BOX 66 DANBURY WI 54830 �� <br /> Property Owner's Mailing Address: , <br /> City State Zip Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 oc_ F.,, (A <br /> a. <br /> Contact's Telephone Number: 715-204-4043 J o <br /> �'ir <br /> Contact's Email: kellee@northcampproperties.com '1 001 <br /> N ro <br /> o CrQ6 <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 a�o. <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> 0 <br /> o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> 11t) <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 C c k <br /> Proposed Use of Structure/Addition: D(�(- C3\ t7 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) a <br /> IE <br /> Building Contractor: Sewer Installer: c <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> —r--- <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 po <br /> 11 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> h�e �tions,and i lz bzznkh ses.�j* <br /> Fee Rec:BI26 <br /> Check#: 24 04/ <br /> �'I Ila 3ilE <br /> Date of staff site visit: Initials of site vis* staff: r <br /> Z. <br /> APPROVED BY LAND SERVICES OFFICIAL:ii <br /> DATE: CI'/23 Z.s/9 <br /> EFH <br /> II <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF I mCn 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> < w <br /> Page 1 of 5ITH <br /> Burnett County, WI Land Use Application—Rev 05/2022 �` 4 <br />