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LAND USE PERMIT APPLICATION — Burnett County, WI y r <br /> C <br /> Applicant Complete All Sections Below This Line z <br /> Permit Types and Fees:(Please,check appropriate boxes) II n' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 \ A) ikNI3 <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 /> C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < tT <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> CP <br /> 'Solar Panels(Stand alone or roof mounted) I$150 t 'Permit Extension(1 Year Extension-Allowed Once) I$100 <br /> 74. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> o <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o �a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o . <br /> p rt NORTH CAMP PROPERTIES V, LLC lm <br /> Pro e Owner's Name: Z. ,. <br /> Property Owner's Mailing Address PO BOX 66 DANBURY WI 54830 Z w <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 54830 State Zip < -- <br /> Property Site Address: - G <br /> a <br /> Contact's Telephone Number: 715-204-4043 N d r <br /> kellee northcam ro erties.com t `�� <br /> Contact's Email: @ PP p _ <br /> Legal Description of Property: Lot 1 GSM 4945 V2(1-'306 UUC4615b8 a <br /> A @ <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND 4 <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 kN tax statement): <br /> 35424 ' o o <br /> Proposed Use of Structure/Addition: 6/-6 5� <br /> 7 <br /> pci: 0 d <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) p <br /> Building Contractor: Sewer Installer: I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY j -L <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 '-- <br /> home additions,and bunkhouses.** <br /> .. <br /> I 1 {{� <br /> Fee Rec:/ •— <br /> Check#:( (/' <br /> cm <br /> Date of staff site visit: 1 2-I 4I 2 O2 Initials of site visit staff: n I- rz <br /> a, <br /> a <br /> z <br /> �? <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIA DATE: I2/Z6/2025 a it ":1-) <br /> < C <br /> n IUU1 d <br /> E. <br /> U PO APPROVAL: APPLIC:A1'v l MU S POS COPY O N j cl1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o 0 0 <br /> z 0111 <br /> c <br /> �Page l of 5 m - m coy <br /> Burnett County, WI Land Use Application—Rev 05/2022 o <br /> l D 3 <br />