2009/05/20 - LAND USE - LUP - Other (3)

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z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g ° APPLICATION FOR LAND USE PERMITS o y w OWPJERVc�yt 1 ' `�SO� TELEPHONE /[J— / C7 �1llOQ a d fir,,// p'1 t� w MAILING ADDRESS Toknspr, FT-eden'C' , PROPERTY ADDRESS SQ me LEGAL DESCRIPTION 0+ '�L cJP TYPE OF PERMIT(S): SINGLE--FAMILY DWELLING ❑ ADDITION 1% DECK ❑ 1 GARAGE/ACCESSORY STRUCTURE ❑ y BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ , 'v COMMERCIAL BUILDING CO MER IAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ 0 I STRUCTURE/ADDITION USE: Q. th � I rpoq, Slf- 1'11 Q%tvI r DXf(0 o (Home/ abin; Commercial/Business; Be oom; Deck; etc.) BUILDING CONTRACTOR: O E + l�O S 11( (Jf 0 n l a o 15, L.'the 1 rdcolfo lu. Gron�-bt ro . W1 Sof 8*0 '188- 3990 < A PLOT PLAN MUST BE PROVIDED ON AN 8 Ih X11 SHEET OF PAPER. NY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) 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 htO 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, AND INDICATE NORTH (N). N 1 0 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 w J O (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 TO BUILDINGS, ROADS, LAKE, LOT LINES. 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. r , 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE / \, ,) PLANS MUST BE SIGNED AND DATED BY THE OWNER. �\ o U NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: WOQ \ 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n O 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Y O TTED. O 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMI 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER to SETBACK AREA. S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. :E 6. 7. p 0 0 o n a n 33 � cE F7 fa z o m m g o EF I dedare that this application(Induding any accompanying schedule)has been examined by me and to the best of my g o ,2 R R R ? w knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all L P.`= Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this > > N Information I am providingwill be relied upon b the County of Burnett Wisconsin in determining whether to Issue a permit. I P Y ty 9 P further accept all liability that may be a result of the County of Burnett relying on this Information[am providing In this v �H in H� application. I agree to permit county officials ed with administrating county ordinances or other authorized person to have ° L) 8 access to the above-described premises at an rea nable time for the purpose of Inspection. m ii o�N o o y b V 1 m n S y won-ow C 5 . OWNER'S SIGNATURE /r` � n sz a o E 2 �I (date .°c2 �''y soya ' K7 ZONING ADMINISTRATOR -• O" � 0_ sct"1 ti w' TOWNSHIP PERMITS MAY BE REQUIRED p; THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE « =N