2012/04/24 - LAND USE - LUP - Other - 35489

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator Pa APPLICATION FOR LAND USE PE ,�MITS a �( OWNER �'�-_(_✓lJ �I)'�tr1yq ✓��%eS�1 TELEPHONE T��—1746 -� 71ie7— d e/SS C� MAILING ADDRESS Q Cr P✓ / WG<-/ R S77s1rz5 ✓V11V 6 J0 S �1 PROPERTY ADDRESS a�CJOPTz/9Pi� ✓)I.SoU/b h/!SC .�S�LS �� o w J 6 LEGAL DESCRIPTION .S /s F SF o TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE w m 0 BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ STRUCTURE/ADDITION USE: Z Home Cabin; Comm rcial Business; /Bedroom; Deck; etc.) 0 BUILDING CONTRACTOR: ONfZ n a O 3 A PLOT PLAN MUST BE PROVIDED ON AN 8 Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS a WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) n a m O 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, d v AND INDICATE NORTH (N). _-Z 'P o 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK5 (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. ! 4. SNOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES SLS ^, TO BUILDINGS, ROADS, LAKE, LOT LINES. 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE N'v' o PLANS MUST BE SIGNED AND DATED BY THE OWNER. NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN _Q NEEDED. � f; 1 THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: O` W 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. d z 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 7' 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER I SETBACK AREA. Q 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. SA&J rt"D by > fir. so/of, 7-At-k- a,-a prom cPvruw��/ � 7. z `A aco o Oa Ob I declare that this application(including any accompanying schedule)has been examined by me and to the hest of my 3 9,°� R w' ��•, knowledge and belief K Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all ,p F ki rrn y Information contained In this application(including any accompanying schedule)and 1 further declare that I recognize that this v 5. 9 9 m Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I a = further accept all liability that may be a result of the County of Burnett relying on this Information I am providing in thisappl accelcation.ss to the above-descdbed preagree to permit m at any officials charged ableht me foadministrating theingrp county inspectionnces. or other authorized person to have o o o to wowwNWn OWNER'S SIGNATURE ZD �Z 1- ton 0 0 0 0 "' seaarn „ O do . dod _50 a y T c y N o 'sl ZONING ADMINISTRATOR n M OWNSHIP PERMITS MAY BE REQUIRED APR 2 0 2012 THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF TSC E BURNETT COU . . . . . ZONING