2014/09/23 - LAND USE - CUP - Conditional Use Permit

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Total Capacity of Camp(in number of persons accommodated at one time) -SWIMMING POOL(Per pool) $300($150 Permit fee+$150.00 Preinspection fee) Type of pool (indicate the number of each type of pool on property in check box) ❑ Cold Soak(below 72°F.) ❑ Diving ❑ Experimental ❑ Swimming ❑Wading ❑ Combination ❑ Exercise ❑ Mobile ❑ Therapy ❑ Whirlpool 'WATER ATTRACTION(Per attraction) $350($175 Permit fee+$175 Preinspection fee) Type of water attraction(indicate the number of each type of attraction on property in check box) ❑ Activity ❑ Leisure River ❑Vortex ❑Zero-Depth Entry ❑ Interactive Play Attractions ❑ Vanishing Edge ❑Wave -WATER ATTRACTION,WITH UP TO 2 POOL SLIDES/WATERSLIDES PER BASIN Note. This section includes any pool with a slide that is not defined as a children's slide per HFS 172.04(8). ❑Water Attraction,with up to 2 pool slides/waterslides per basin $500.00($250.00 Permit fee+$250.00 Preinspection fee) ❑ Per Watersude or Pool Slide, in excess of 2 per basin $300.00($150.00 Permit fee+5150.00 Preinspection fee) 'Department of Commerce plan approval required for new/altered/modified pools. TATTOO&BODY-PIERCING ESTABLISHMENTS ❑ Tattoo Establishments 5390.00($135.00 Permit fee+$255.00 Preinspection fee) ❑ Body-Piercing Establishments $390.00($135.00 Permit fee+$255.00 Preinspection fee) ❑ Combined Tattoo/Body Piercing Establishments $620.00($220.00 Permit fee+5400.00 Preinspection fee) ❑Temporary Tattoo Establishments $100.00 ❑Temporary Body-Piercing Establishments $100.00 ❑ Combined Temporary Tattoo/Body-Piercing Establishments $100.00 Temporary permits are valid no more than 7 days per event. State of Wisconsin Tattooist/Body-Piercer ID No.: Expiration Date: Check the appropriate box when your business is in operation. _ Wit " ko_h 0r CtvN\c, C"< 10 Year Round r� FI Winter El summer CUV�fx Olx>,. ru Ms �"VYU9 b TOTAL AMOUNT ENCLOSED:�J,^ � vY' 0. UQyJ' Your signature below will acknowledge that you have received a copy of the code or information as to where to obtain a copy and will comply with all applicable Wisconsin Administrative Code(s). SIGNATURE—Applicant T Chapter 254.47(5)and 254.64(1)(c), Stats. "No Dertnit may be issued until all applicable fees have been paid.' Chapter 254.47(1), Stats. "No person...who has not been issued a permit under this section may conduct, maintain,manage or operate a campground and camping resort, recreational camp and educational camp or public swimming pool,as defined by department rule.' Chapter 254.64(1)(a), Stats. "No person may conduct, maintain, manage or operate a hotel, restaurant, temporary restaurant,tourist rooming house,vending machine commissary or vending machine if the person has not been issued an annual permit by the department or by a local health department that is granted agent status under s.254.69(2)' Chapter 254.47(4)and 254.64(5),Slats.,and HFS 173.04(2a),Wisconsin Administrative Code. Permits released April 1 and after expire June 30 of the following year. Within 30 days after receiving a complete application for a permit,the department or its agent shall either approve the application and issue a permit or deny the application. If the application for a permit is denied,the department or its agent shall give the applicant reasons, in writing, for the denial. A permit shall not be issued to an operator without prior inspection. Submit completed application and check to: Food Safety and Recreational Licensing - 1 West Wilson Street, Room 150 P.O. Box 2659 Madison,WI 53701