2010/08/11 - LAND USE - LUP - Other

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N z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a 0 „ APPLICATION FOR LAND USE PERMITS n� a OWNER TELEPHONE rso`�, Z4 I•S� �f O R�Nb e NEIO�r_ I ICor�NIf \ o 0 MAILING ADDRESS FA t-I S^ioES TER-a-Ac,6 c^tr-E oS'Ef�o 2 X410 PROPERTY ADDRESS 2� 'f G�( cl�i✓/� "W_A_ p_p 7Rc n�' l W I o < 1 LEGAL DESCRIPTION S Z T40 TYPE OF PERMIT(S): SINGLE-FAMILY DWELLINGJQ ADDITION ❑ DECK 0 GARAGE/ACCESSORY STRUCTURE ❑ 4 BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ ACA— COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE 11a 3 fi STRUCTURE/ADDITION USE: �� Wl G (�/�B //tet o A _- (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) - BUILDING CONTRACTOR: W Ot2-ir�— GON 2J c r7 n ,� (5333 w. STATE 2-7 -7'7 MewAn1� WI 54�kZ A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2X11 SHEET OF PAPER. ANY I COMPLETE OR ILLEGIBLE PLOT PLANS C o _ WILL BE RETURNED. (�lrt•, 'n DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) .` k-/ tnn 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 M 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, B AND INDICATE NORTH (N). 1 No 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) Q TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S^'C (OHWM) OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. O 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES n, TO BUILDINGS, ROADS, LAKE, LOT LINES. 1 m 9D 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. t go6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE 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 NEEDED. l � � I THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r � O 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n Z O 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 1 x. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER U� SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR MUMAN HABITATION. 6. WSf1�C vCtif,'GQ bH C(- ljConroy based Or ptpeS )e4by igvnswensan,"00( F 7. Sl.r.✓V4VO✓. .. A a o 0 o n a 0 'C yzo � R � oss3 I declare that this application(including any accompanying schedule)has been examined by me and to the best of my g o ,2 P R knowledge and 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 =9 D ro N Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I .. ,��, 4 ao _ > 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 person to have ;�, J o o R o .r. access to the above-described premises at any reasonable time for the purpose of inspection. a n o 0 0 o y OWNER'S SIGNATURE ��y`'- �"'c 'h'f'„" 065; Lw v, Ln0 v a : (date) F[�n scan N ZONING ADMINISTRATOR �irn— y _ TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE a ` P in i f f Z acted A� -TWO fr&C)aS"CJ74 f, V g 8-9-/d