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ADDITIONAL PROVISIONS <br /> • Removal or cutting of trees and vegetaticn,as well as filling and grading are restricted within the shoreline e rea. Restricted <br /> shoreline area is all area from the OHWNI to 50 ft from the OHWM landward. Contact the Land Services D.partment prior to <br /> cuttim any shoreline trees and vegetation. <br /> • No str'Lctures are allowed within any setback,unless specifically permitted. <br /> • Driveway must meet width/height requirements within 60 days of permit ssuance date. <br /> • Accessory structure/garage permits allow for private residential storage only. Not to be rented or used for human habitation. <br /> • TOWN/UDC PERMITS MAY BE R'sQUIRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS <br /> RESPONSIBLE FOR CONTACTING THEIR TOWN FOR MORE INFORMATION. <br /> • THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE.ONE EXTENSION 14[AY BE GRANTED. <br /> • THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT co ACCESS AND/OR <br /> REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <br /> You (owner) ire responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <br /> Wetlands that tre not associated with open water can be difficult to identify. Ft-ilure to comply may result in removal or modification of <br /> construction tl-at violates the law or other penalties or costs. For more inform---ion visit the Department of Natural Resources wetlands <br /> identification. 'eb page or contact a Department of Natural Resources service cen ar. <br /> I(owr:er)declare that this application (including any accompanying crawings and plans)has been examined by me,and to the best o <br /> my kr,owledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of al; <br /> information contained in this application (including any accompanying drawings and plans), and I further declare that I recognize <br /> that this information provided will be relied upon by Burnett County in determining whether or not to issue a permit. I accept all <br /> liability that may be a result of Burnett County relying on the information I am providing in this application. I acknowledge that I <br /> will abide by all private/public covena•its, restrictions,leases an easements which may apply to this rarcel. I agree to permit county <br /> officials charged with administrating County ordinances or other authorized persons to have access t3 the above-described premises <br /> at any reasonable time for the purpose of inspection. <br /> ---ADDITIONAL COMMENTS FRO OWNER ALLOWED HERE--- <br /> OWNER'S SIGNATURE:/24 .. ' <br /> G� `a j a o,1 <br /> (DATE) <br /> Property Owner is required to sign E td date this application. <br /> SUBMIT COMPLETED APPLICATION,MAPS, PLANS AND FEE TO: <br /> BURNETT COUNTY LAND SERVICE S <br /> 7410 COUNTY ROAD K,#120 <br /> SIREN, WI 54872 <br /> APPLICATIONS WILL BE ACCEPTED VIA USPS,ANY STANDARD COURIER,OR IN PERSON. PARTIAL OR INCOMPL?;TE <br /> APPLICATIONS WILL BE RETURNED TO THE APPLICANT. NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br /> ONLY CHECK, MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACC ',PTED <br /> AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SERVICES <br /> Please call the Land Services D partment if you have questions. 715-349-2109 <br /> Burnett County,WI ordim nces can be found at: http://www.burnettcounty.com/ind.x.aspx?NID=1043 <br /> Page 3 of 4 <br /> Burnett County, NI Land Use Application— Rev 12/2020 <br />