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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> C7 I <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <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 /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk 18unkhouse $250 <br /> Driveways/&Campground Structures $125 jWl State Statute 59.692(iv)Structures $350 r N <br /> o <br /> Filling/Grading $150 lBoathouse $500 <br /> Solar Panels (Stand alone or roof mounted) $150 IPermit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits (permit aquired after construction has begun)may cost up to three times the normal fee. <br /> rD <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> 0 <br /> Property Owner's Name: NORTH CAMP PROPERTIES V, LLC o <br /> a <br /> Property Owner's Mailing Address: PO BOX 66 DANBURY WI 54830 ty c <br /> 29221 HAYDEN LAKE ROAD DANBURY WI 54830 State Zip c <br /> Property Site Address: � <br /> Contact's Telephone Number: 715-204-4043 t`moo G� o <br /> Contact's Email: kellee@northcampproperties.com <br /> Legal Description of Property: Lot 1 CSM 4945 V27P306 DOC461558 W <br /> Section#: 05 Town#: 40 N Range#: 16 W Town of: OAKLAND <br /> H. <br /> d O <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 Q o <br /> Proposed Use of Structure/Addition: d,t dl- (QA.r'P,6l, *Lu) 4- G&cd t7 <br /> Anticipated Start Dater .(jc�eam?, _ (Home/ abin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: Q <br /> N <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 UDClnspector 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 /> Fee Rec: 5 <br /> Check#:L' <br /> (� 8 <br /> Date of staff site visit: Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:' I .2 `� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 03 <br /> a. <br /> r(�tu <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT co0 <br /> r- - <br /> o <br /> Page 1 of 5 a <br /> Burnett County, WI Land Use Application —Rev 05/2022 - <br />