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Proposed buiklinWbtruclure los'ations aulst be slaked prior to aubmitling Ibis applicntioP to the/Ailing Office. Coualy staff <br /> will da an on vile visit IU verify site conditions, If all proposed structures(Including docks,patios,retaining walls,etc)are <br /> not%toksvt upon County staff s!sit.Arc permit will NUT be issued and it will be returned to the applicant. <br /> If 1l.riolsting%trochtl•es ooh the parcel are nor shown and dlmeoisioned on the plot plop drawing.the lxrndr will NOT be <br /> issued and it will lx returned to the applicant. <br /> 'I'lil5 PERMIT IS SUBJFCT 1'0 AL1.,CONDITIONS LISTED BELOW: <br /> e Removal or cutting of trees and�egctatiLit)is restricted within floe sbrnreline arca. It"ttiotcd shorclinc arra is all area from lite <br /> OilWkI to}O It 11\1111 the OH1whil. (_nntact the Mining Office prior to culling ens stanelinc trees acrd vcyetatian. <br /> No saurmrcslinrinding retaining wills,etc.)ant allowed within any setback,unless specifically Pennitrcd. <br /> \o tilling,grading,or share 1Knu altcnttions are allow cd unless specifically permitted. <br /> t)riteway must ntccl W'idih'heighl reyuirooincnts within W days nl'pelnlil issurulcc talc. <br /> Aelaswry suuctunrgKhage permits allow Cor private rrsidenbal storage only. "•Vol to he.used tis human hmbltatioo or rcPWl <br /> storage' <br /> ••1'O\V'NIUDC PF:RM1117S M1IAY' BE REQUIRED. OWNER It;RF,%p0 N.%;IBLE FOR CONTAC"fINC:THIS TONN FOR hIORE <br /> INFORMATION. <br /> "THIS PFRh117'SHALL PAPIRY.ONE YKAR MOM UATF,OF ISSU4.N(.F <br /> You (owner)we responsible for conipl)mg with state and federal laws concerning construction near or till wetld"Lls- lakes, and s reams. <br /> Wetlmlds that arc Pot assariated ovhh opal water can lie difticult to identify. fuilury to comply mny fault in removal or modification of <br /> construink"i that violates the law or (11110-pcnahics or costs. fila mroro information visit the Department „f Natural RC.sauNLN wetlands <br /> ideutiFcatit'll web page or cont, t a l)epLinrtent u(Naturd Rcsaurces service center, <br /> 1 pownerl declare thal this application (including any acconyranying drawings mud phots) has been examined by ate and to the best <br /> of my knowledge mutt belief it is true, correct void tomplete. 1 acknowledge that I •ern I rsponsihle for the detail and accuracy of all <br /> information coulmineil in this appllcmtiuu(including any accompanying drawinp;a and plans) and I further declare that I recognize <br /> that this information provided will be relied upon by llurnett Corudy to determining whether to issue a Permit. I further accept all <br /> liability that may be a result of Burnell County relyinC nn the infornhalion I atn providing in this appiication. I acknowlediAt that I <br /> will abide by all privolelpmhlic Covenants, reetriclions, leases and easewrids which Piny apply tit tilts parcel. t agroe to permit <br /> coanty aMcials charged with adminlstrating county ordlnaaces or other authorised perilous to have acems to Ate above-described <br /> prem[ses at any reasonable time for the purpuse of inspection. <br /> ADUI1'10NAI.COMMEN l ti MINI OWNER Al I UWLI)11FRl'• <br /> �J <br /> OWNER'S SIGNATURE:_,. <br /> IPA F:) <br /> ✓logic") Ownct i1 fl'lt&Ld IU thgll Kad doth'Ans Appl,lalitill. <br /> SUBMIT COMPLETE)APPLICATION,MAPS. PIANS AM)FEE TO, <br /> BURNETT COUNTY 70NING <br /> 741000UN1Y ROAD K. ani: <br /> SIRMI,WI 54972 <br /> APPLICA I IONS WILL BL AMPTED VIA I TSPS.ANY STANDARD COURIER.OR IN PERSON. PARTIAL.OR INCONIPLETV <br /> APPLICATIONS WILL Bfc RETURNED TO TI 03,APPLICAN'h. <br /> NO EMAIL OR FAX APPLICATIONS W111 I. OF ACCEPTED, <br /> Page 3 d S <br /> Burnell C'ounty, WI land Ilse Application-- Rev 1/2016 <br />