2016/01/11 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS 6i' y G 1 OWNER \ o CA 0 SCA TELEPHONE EM 7 35 O PROPERTY ADDRESS LEGAL DESCRIPTION -� P' 075u n ,�77 CkeY '' in p�clL5L MAILING ADDRESS o 01 Glpoone�'I/ )dl TYPE OF PERMIT(S): 3^\ ❑ Single Family Dwelling ❑ Garage/Accessory Structure ❑ Stairs ❑ Commercial Building 1C 6 &Addition ❑ Bunkhouse ❑ Filling/Grading ❑ Commercial Addition ❑ Deck ❑ 59.692(iv)Gazebo ❑ Camping Unit ❑ Commercial Acc. Structure 7 ff L, (/ I75-1 STRUCTURE/ADDITION USE: l�Cn ;y� 1 e i'" L �L��;ti'� —� iR z (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) 11W ;04 � BUILDING CONTRACTOR: VCS W iC{4 1 Ci✓(71 I:) Gi( '�1 O ' n b PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. � o y � ***REQUIRED PLOT PLAN INFORMATION*** �' f tl 81/2"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: I d ❑ DRAWN TO SCALE OR DISTANCES LABELED © WELL D PROPOSED BUILDING/STRUCTURE LOCATION d SEPTIC TANK&DRAINFIELD a 4Dimensions&Heights O ROAD RIGHT-OF-WAY IF SURVEYED Q EXISTING BUILDINGS/STRUCTURES(Includes deck, porch, etc.) CENTERLINE IF NOT SURVEYED 5 4Dimensions&Heights (D ALL PROPERTY LINES d ❑ NORTH ARROW (a ORDINARY HIGH WATER MARK ❑ ALL WETLAND AREAS � y NOTE: Building/structure location must be staked for onsite verification when needed. D �/�a� THIS PERMIT IS SUB3ECT TO ALL CONDITIONS LISTED BELOW: • Removal or cutting of trees and vegetation is restricted along shoreline v • No structures(including retaining walls,etc.)are allowed unless specifically permitt AUG 15 2014 )4�:: • No filling,grading,or shore land alterations are allowed unless specifically permitted • Driveway must meet width requirements within 60 days of permit v • Accessory structure/garage permits allow for private residential storage only BURNETT COUNTY** n Z v Not to be used for human habitation or rental storage** ZO a N _ y ^r I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and d belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information contained in this application(including any accompanying schedule)and I further declare that I recognize that this information provided will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. � / I p VE n � � 000Vo ADDITIONAL CONDITIONS L hl:� Ol ry ° 3 3 3 R a ''I`�7 In' 3 3 3 �� 1 !r 'i C_ CG�\,� �V S � �� y � o ro ro ro 0 o a a m E. �{�/ $` �n Hexa ,�, � APR 2 2 = a ' N V v^ 9�P1 \O ��'p � � arm Ma� Yla e._ �..1�It�nv� � � g• t BURNETT COUNT-Y m a 8 s o z 17N, OWNER'S SIGNATURE ZONING OFFICIAL o (date) 00 **TOWN/UDC PERMITS MAYBE REQUIRED **THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification , of construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources v N wetlands identification web page or contact a Department of Natural Resources service center. ^ ^ 0 0 0 0 8