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LAND USE PERMIT APPLICATION - Burnett County, WI f r <br /> Applicant Complete All Sections Below This Line '6 ' W <br /> Permit Types and.Fees:(Please,check appropriate boxes) 4 a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 7 ti <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ^i <br /> NJO <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk)( <br /> Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- 1' <br /> Filling/Grading $150 Boathouse <br /> $500 <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> lb <br /> *NOTE:After-the-fact permits(permit aquired 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. 0.. g . <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z ,b <br /> p <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC 0 <br /> n <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 F. n <br /> City State Zip "i <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 <br /> n <br /> n. <br /> Contact's Telephone Number: 715-204-4043 C7 <br /> Contact's Email: kellee@northcampproperties.com <br /> N -a <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 n„ <br /> 100, <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> 5 <br /> 5. <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 /— c4 o w <br /> Proposed Use of Structure/Addition: 1-e.02,- 5 LA--S- ( - , .j a e <br /> Anticipated Start Date: (Home/Cabin:Commercial Burinerc;Bedroom;Deck:etc.) !. <br /> �J`� .- <br /> Building Contractor: Sewer Installer: Z 1 <br /> G <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY --r— <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant need cony...; if a perm:, prior tt, <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> tr <br /> 0mee4 all s <br /> gil WV • Gtl /10444- 1:414-tg:M, ,,f�VC' — / ,f L — / Fee Rec: 9�J <br /> #.7 ,ze, DeG�/6/4.4 ame 5N�/ d tcirct be <tir�'/ e - Check#: 55. <br /> Date of staff site visit: q 'All 1 23 Initials of site visit staff: rigs I. kr <br /> Ni4 <br /> ))16/l!� �Q�ljpt <br /> 117f <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 33 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF _ '. � li- <br /> „, <br /> a , • <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z ,� �'; <br /> 4 <br /> Pagelof5 R4 <br /> EN <br /> Burnett County,WI Land Use Application—Rev 05/2022 < .........,i <br /> 0 <br /> 3 <br />