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• LAND USE PERMIT APPLICATION —Burnett County, WI E i <br /> Applicant Complete All Sections Below This Line 5' <br /> Permit Types and Fees:(Please,check appropriate boxes) a zitCF <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1 "&. <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 p <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 e r <br /> Driveways/&Campground Structures $125 WI State Statute 59,692(1v)Structures $350 S f,, <br /> 4. <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand a lone 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. 'ti s <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. S+ w <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. AO <br /> . N <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC <br /> Property Owner's Mailing Address: <br /> PO BOX 66 DANBURY WI 54830 n V <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 548C3 State Zip o in <br /> Property Site Address: � <br /> a <br /> Contact's Telephone Number: 715-204-4043 v a <br /> k <br /> Contact's Email: kellee@northcampproperties.com ., <br /> Legal Description of Property: t 12 0 o <br /> Lot 1 CSM 4945 V27P306 D0C461558 5 <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND w <br /> _ <br /> 2 <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 tatement): 35424 C <br /> Proposed Use of Structure/Addition: Comp l e t e W 5 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) y \. <br /> Building Contractor: Self Sewer Installer: no sewer -- <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 determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured ,H. <br /> home additions,and bunkho ses.** <br /> 0Me t1.(1 Sel ac�-S <br /> Fee Rec: 1 L5 <br /> 4 Cheek#: <br /> / �� h~a# �2-O.//2 <br /> Date of staff site visit: 10/10/?3 Initials of site • 't staff: `� D(. 2 <br /> APPROVED BY LAND SERVICES OFFICIAL:iii+'z DATE: /0 kc23 1 _3 C� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a a u, fi <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o N <br /> C <br /> ff <br /> Nij <br /> .e vo <br /> Page l of 5 w N C <br /> Burnett County,WI Land Use Application—Rev 05/2022 5 `.- u <br /> G <br /> 5 <br />