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V. <br /> j LAND USE PERMIT APPLICATION —Burnett County, WI a b r <br /> b <br /> . Applicant Complete All Sections Below This Line 5 � <br /> Permit Types and Fees:(Please,check appropriate boxes) `� <br /> 1F <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure • $200 <br /> e-- <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 C, O <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 /> yx <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° U Z <br /> CT <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- <br /> Filling/Grading $150 Boathouse $500 r <br /> cn <br /> Solar Panels(Stand a lone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 m <br /> g. <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. r 11 <br /> 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o lir <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC g <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 cp a., <br /> City State Zi \• <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830 p o_ <br /> p 715-204-4043 �? <br /> 0. <br /> Contact's Telephone Number: d <br /> V <br /> kellee@northcampproperties.com 4 is 3 0 <br /> Contact's Email: I[ <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 4' !! <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: <br /> OAKLAND <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> a, <br /> Tax ID#(I-5 digit number;found on tax statement): 5424 c w <br /> (,� �� 0 x <br /> Proposed Use of Structure/Addition:9F(.I�l'1 5 4 — <br /> Anticipated Stan Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) —1 O. LA <br /> Building Contractor: Sewer Installer: i •-rm.— <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant needs to contact their UDC Inspector to deternrirte if a permit is needed from them prior to <br /> ANY construction taking place fir any dwellings,dwelling additions,manufactured lw;nes,manufactured <br /> home additions,and bunkhouses.** <br /> 1�1�11 eel— cv as -fie • <br /> --� <br /> -I <br /> Fee Rec: [2`J - <br /> t- Check#:i(o-2( , <br /> 0 <br /> Date of staff site visit: 1//0123 Initial of site vi it staff: l r <br /> t / <br /> APPROVED BY LAND SERVICES OFFICIAL: I / DATE: `v1�06,3z �--J� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFF. g E <br /> ..3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z E <br /> i- <br /> CD c NJ <br /> Page l of 5 n - wCC <br /> Burnett County, WI Land Use Application—Rev 05/2022 < ( , [f 1 <br /> J <br /> I <br /> 4 <br />