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r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> O' <br /> Applicant Complete All Sections Below This Line 9' <br /> e tn1 <br /> .Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,D. <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> KAccessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150cn ' •-• r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° • <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 l� <br /> i <br /> Filling/Grading $150 Boathouse $500 ci, <br /> w <br /> Permit Extension(1 Year Extension Allowed Once) $100 LI 44, <br /> • <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. o 5• <br /> 4 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o rr <br /> 7 — <br /> North Camp Properties V, LLC DBA DuFours Campground 0 '� <br /> Property Owner's Name: 1 <br /> PO Box 66 DanburyWI 54830 w c' 1' <br /> Property Owner's Mailing Address: r <br /> h City State Zip o <br /> Property Site Address: 29221 Hayden Lake Road Camp Site#: Y rD <br /> n <br /> Contact's Telephone Number: 715-204-4043 -:CI C <br /> Contact's Email: kellee@northcampproperties.com <br /> S <br /> Legal Description of Property: Lot 1 CSM 4945 V27 P306 at <br /> e <br /> Section#: 6 Town#: 40 N Range#: 16 W Town of: Oakland <br /> *Attach additional page if needed jra 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 ,--1 <br /> w <br /> ❑ 5 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: ('Home/Cabin;Commercial Business;Bedroom:Deck;etc;) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <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,dwellin«additions, manufactured homes, manufactured is- <br /> home <br /> additions,and bunkhouses.I** V PO(J wY•1 T v 5•/1!nv1,S <br /> QII tciii- ` l o a:r �r WR.1IS. <br /> C3' ! <br /> i41- �p( �'! 'ystl 2 Fee Rec. (9��ea <br /> filee,-1- <br /> ge/rWe PXre55 outs c,I)o„ ( h .(S Cheek#:I * —� kT ° <br /> Date of staff site visit: 1 `�I l I itials f site visit ff: <br /> rn <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 7ICV/P3 < r <br /> r � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF u m m m 0 <br /> ; G <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z N a r-, on! <br /> Pagelof5 rn .'� w <br /> Burnett County,WI Land Use Application —Rev 12/2021 U�lU <br /> as �J0 <br /> a- <br />