2014/01/02 - LAND USE - LUP - Other

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y Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g _ APPLICATION FOR LAND USE PERMITS = fi OWNER 12ll 1 ALJ_`w Ii ltyr �IC 62mp TELEPHONE -j 15 �gA 23,L�7 Ur Pr1 � IC MAILING ADDRESS 11515 LMl�T�� Polwh r,8 t &nxvvk ,.,,,,. 0.940 PROPERTY ADDRESS S25 L4.+f - - I"OIvi`. n 1' �r �L.yr ys.. "Wo LEGAL DESCRIPTION /a- �br"� F�'^ I� F-0i�--Q = lir-41— TYPE OF PERMIIIB): SINGLE-FAMILY DWELLING 0 ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ BUNKHOUSE 0 59.692(IV)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 1 8 COMMERCIAL BUILDINGS Multi ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE Cl M _ STRUCTURE/ADDITION USE: - Ux' &a"In!r '� S'jt'Z,,_ z CT1 (Home/��C��abin; ComAm_ cial�r-� Business; Bedroom; Deck; etc.) 11rV�" BUILDING CONTRACTOR: W Vt l.0'/s S�l'e1d 11A't a �1nG. (xAkT.4s 1" ' = s n1 - - N A PLOT PLAN MUST BE PROVIDED ON AN 8 K X11 SHE OF PAPER. ANY INCTPLJETEOR ILLEGIBLE PLOT PLANS WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 1vQ,'1 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW BUILDINGS/STRUCTURES INS), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, g 03' AND INDICATE NORTH (N). F Cl 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENTS)TO THE ORDINARY HIGH WATER MARK A"U (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. I p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST) AND DRAINFIELD(DF), AND ALL DISTANCES 9% _. I TO BUILDINGS, ROADS, LAKE, LOT LINES. S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. CIO 7` / y 4yyJJJ-/y 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE W. PLANS MUST BE SIGNED AND DATED BY THE OWNER. GO NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN In NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: - Lu 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. r; {IIISVVV. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. z 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NRRT��TO BE USED FOR HUM/pN HAA/BIITATI �L "� /)� 6. �if� ��Ll /cJ VH ��ic 0f)� hlt� RLC,/ , 7. 6z n^ ^. o >- - 1 declare that this application(Including any accompanying schedule)has been examined by me and to the best of my s c knowledge and belief It Is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of all - - _ Information contained In this application(Inducing any accompanying schedule)and 1 further declare mat I recognize Nat this Information I am providing will be relied upon by the County of Burned:Wisconsin In determining whether to Issue a Penni[. I =_ ' further accept all liability that may be a result of the County of Burnett relying on this Information 1 am providing In this lE _ apDliptlon. I agree to permit county ofBdals charged win adminis[2tln cpunry preinanas or Omer authorized person to have access to the abave-desorhad premises at any ee a ble a mr t urpose of lnspMlon. � OWNER'S SIGNATURE �nIIIIIt�`\t\`Vy1/n�f1t 12r / nn t1_S!_� _ _ P E = L ZONING ADMINISTRATOR '- -P : '_ c gm_ TOWNSHIP PERMITS MAY BE REQUIRED $EP 9,2013 THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS Ct '-- SSo4_ BURNETTCOUN ZONING