2014/11/18 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator C' APPLICATION FOR LAND USE PERMITS - A OWNERTELEPHONE - I Lv�oT(fY q-�� --C:>AV�. ro51 2z/v-C�oO3 _� c� PROPERTY ADDRESS D- 11 Al Sl'- KZ'y- � /Lyb:s 2 (p�1 SC, -If293 O C LEGAL DESCRIPTION �CC r'C Z 1 SEcorV :7,.q ' MAILING ADDRESS _ vets spr�f�woe,� blz- Zs- TYPE 41�or�c�rzti ✓`ink SSiS _ TYPE OF PERMIT(S): Single Family Dwelling ❑ Garage/Accessory Structure ❑ Stairs ❑ Commercial Building = �. ❑ Addition ❑ Bunkhouse ❑ Filling/Grading ❑ Commercial Addition ❑ Deck ❑ 59.692(ly)Gazebo ❑ Camping Unit ❑ Commercial Acc. Structure 3 STRUCTURE/ADDITION USE: Cort}Up2j/.UV C�XIS/n/6 (-'�}f?y GC-, Tm R tyQ✓N E. (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: EXi3T-vb QiStLPLyf6 _ $tZ.� T --� U� PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. i ***REOUIRED PLOT PLAN INFORMATION*** ra _g • ❑ 81/2"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: go ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK& DRAINFIELD -)Dimensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch, etc) -)CENTERLINE IF NOT SURVEYED 4Dimensions&Heights ❑ ALL PROPERTY LINES o ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK ❑ ALL WETLAND AREAS NOTE: Budding/structure location must be staked for onsite verification when needed 1I1r sI��11t'I III M1r�� THIS PERMITIS SUBJECT TO ALL CONDITIONS LISTED BELOW: ILJ/ LbIJ�� II LS • Removal or cutting of trees and vegetation is restricted along shoreline ,`ItLWY,T=�I'(YII1 • No structures(including retaining walls,etc.)are allowed unless specifically permi NOV s 2014 • No filling,grading,or shore land alterations are allowed unless specifically permitt • Driveway must meet width requirements within 60 days of permit • Accessory structure/garage permits allow for private residential storage only BURNETT COUNTY **Not to be used for human habitation or rental storage^ I declare that this)application(including a n scbetlule h andknowledge 00 ( 9 ny acknowledge that g 7 as been the dotal by a to of best at iantl belief it is frog correct and complete. 1 acknowletlge that[am responsible far Me tletail and accuracy of all information containetl in this application he County any accompanying n in dale)and 2 further whether to iss Iha[ 1 recognize that this information y thatetl will be result upon by un County a Burnett Wisconsin in )tion I am villinin issue a permit I further accept all liability that may be a suit dRM1e County of Burnett relying on this information]am urns providing in His application. I agree to permit county officials reaup H sonable with for county ordinances es or other authorized persons to have aaesztothe above-0escribetl premises at any reasonable time fur Me purpose of inspection. ---ADDITIONAL CONDITIONS n� = > ni C _ OWNER'S SIGNATURE or ZONING OFFICIAL it 13 y0/q **TOWN/UDC PERMITS MAYBE REQUIRED **THIS PERMIT SMALL 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. y L 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 = wetlands identification web page or contact a Department of Natural Resources service center.