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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> t, <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 2- <br /> -Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> • <br /> X r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o r* <br /> Filling/Grading $150 Boathouse $500 • <br /> F. <br /> Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. - A <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o @. 0 <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. p <br /> Property Owner's Name: North Camp Properties V, LLC DBA DuFours Campground <br /> r <br /> w.o. <br /> [ti <br /> Property Owner's Mailing Address: PO Box 66 Danbury WI 54830 I • <br /> rty State Zip r <br /> Property Site Address: 29221 Hayden Lake Road Camp Site#: S r <br /> 715-204-4043 t� <br /> Contact's Telephone Number: -, . <br /> Contact's Email: kellee@northcampproperties.com N <br /> fro <br /> E. <br /> Legal Description of Property: Lot 1 CSM 4945 V27 P306 e <br /> Section#: 6 Town#: 40 N Range#: 16 W Town of: Oakland a <br /> *Attach additional page if(needed fin-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 '� x <br /> t g Proposed Use of Structure/Addition: <br /> -i <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> 01 <br /> Building Contractor: Sewer Installer: !. -- - <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> z <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 there prior to <br /> ANY construction taking place,Jor any dwellings, dwelling additions,manufactured homes, manufactured c— <br /> honre additions,and bunkhous s.** <br /> �pMr fie# ll ;�-�,� ..�ia��� <br /> 0 -4 Fee Rec. <br /> / I r• G,f' ww 15 <br /> 65CrtenYI ►Mbes� �/e .�rec�SiDre,+ a, O Check#: U Q <br /> q A a <br /> Date of staff site visit: 3 Initials o site visits ff: °7 Rae •Suocarn <br /> b <br /> 2 <br /> q/a 712-3 ° <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: < m �' <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF g W Cr, <br /> 4 3 '� <br /> n�p u i. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o 0 0 <br /> ., CD c cz <br /> m Ii's <br /> Pagelof5 m 3 <br /> Burnett County,WI Land Use Application —Rev 12/2021 <br /> m L _ �' <br /> ° <br /> a <br />