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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> b <br /> Applicant Complete All Sections Below This Line <br /> a \ <br /> Permit Types and Fees:(Please,check appropriate boxes) C7 p <br /> w N <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 r; <br /> Commercial/Industrial Structure $300kAdd <br /> n/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150n/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200n/Alteration to Bunkhouse $150 n <br /> / Deck/Stairs/Patio/Retaining Wall/Sidewalk use $250 - <br /> (., <br /> Driveways/&Campground Structures $125e Statute 59.692(iv)Structures $350o <br /> Filling/Grading $150use $500Solar Panels (Stand alone or roof mounted) $150Extension(1 Year Extension-Allowed Once) $100 <br /> m <br /> I � <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. j . <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 o 0 <br /> Property Owner's Mailing Address: <br /> PO BOX 66 DANBURY WI 54830 <br /> Cit #atState Zip o <br /> Property Site Address: 29221 HAYDEN LAKE ROAD DANBURY WI 54830y <br /> � a <br /> Contact's Telephone Number: 715-204-4043 4 d <br /> Contact's Email: kellee@northcampproperties.com o -� <br /> .� <br /> � r <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 <br /> N <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND ° <br /> ":4ttach additional page ifneeded for lengthy description OR attach a copy of the deed OR attach tax system propene•page. <br /> Cn <br /> Tax ID#(1-5 digit number;found on tax statement): 35424 0 0 k <br /> Proposed Use of Structure Addition: ee <br /> Anticipated Start Date: — (Ho /Cabin;Com ereial Business;Bedroom;Deck;etc.) <br /> :Building Contractor: . � Sewer Installer: <br /> i <br /> ARIEA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z Z <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 17 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> Fee Rec: <br /> y Check#: 311 n <br /> 0 <br /> Hate of staff site visit: Sf 29 25 Initials of site visit staff: DB <br /> z <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: S���ZaZS r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF cn co a 7-1 �Fin] <br /> D Z. "� P <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z <br /> G <br /> Page I of 5 m C°M <br /> m � <br /> Burnett County, WI Land Use Application — Rev 05/2022 <br /> a <br /> b <br />