2012/07/06 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a APPLICATION FOR LAND USE PERMITS L OWNER fe TELEPHONE ql�Z MAILING ADDRESS JN S(D(__ Q o©(K A�moMIV O �jSarry' N PROPERTY ADDRESS ZZa Q C- 5?J/U rjez. 3S TawN 3�5 (SOL AUL 17 �,1 o pz loo y LEGAL DESCRIPTION Q o TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK EI GARAGE/ACCESSORY STRUCTURE ❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ IU7 COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑/ COMMERCIAL ACCESSORY '"STRUCTURE /�❑ STRUCTURE/ADDITION USE: &Ce55ory,�7l(Qarg: &Oef)A", [MT W-% ; (.�'14 5bot -12 )(20 (Home/Cabin; Commercial Bu ness; Bedroom; Deck; etc.) BUILDING CONTRACTOR: U 1 In A PLOT PIAN MUST BE PROVIDED ON AN 8 V2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O _ WILL BE RETURNED. c a DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) r" 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 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, G +— a AND INDICATE NORTH (N). J o c 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 4- (� (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES a r TO BUILDINGS, ROADS, LAKE, LOT LINES. U.I ,o, �m 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ,y 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE U) h PLANS MUST BE SIGNED AND DATED BY THE OWNER. 61 �U�) NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN h NEEDED. THIS PERMIT IS SUBIECr TO ALL CONDITIONS LISTED BELOW: 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n y 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. IN IIS 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. NOT TO BE USED FOR HUMAN HABITATION. / 6. kbTe: AY�'It 4.4xeS 51XC of &ACohrtY'aratl c-4, r1 fv 12'K24'u6i1r6y mate "-,M s 7. b4h" aqv( 4 r2 X l2' 5cOwen t*" on A.lk Sole. a a o a 9 zon I declare that this application(Including any aocopanying schedule)has been examkKd by me and to the[rest of my m 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(iciWYg any a000ngaryYg sOredule)and I further declare that I recogntm that this Information I am providing will be relied upon M the County of Burnett In determining whether to Issue a permit. I k ?m b further accept all Itabtltty that may a'esuH of the County of Burrett on this in(omration I am providing in this c '" =u" = r`; 'd application. I agree to permit o lals charged with adminlstratl my ordinances or other authorized person to have _ o o o o access to the above-descrl p any ane rt Inspection. 3 m n o 0 0 0 0 C=q52 y'zG Ff�/ OWNER'S SIGNATURE Ya a m m m _ Z �d ZONING ADMINIST T R _ � _ _ _ _.... u _ TOW HIP PERMIT MAY BE REQUIRED IUL -2 2012 THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS CC o N "A o � Uo � � oo BURNM COU ZONING