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THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • Removal or cutting of trees and vegetation is restricted within the shoreline area. Restricted shoreline area is all area from the <br /> OHWM to 50 ft from the OHWM. Contact the Zoning Office prior to cutting any shoreline trees and vegetation. <br /> • No structures(including retaining walls,etc.)are allowed within any setback,unless specifically permitted. <br /> • No filling,grading,or shore land alterations are allowed unless specifically permitted. <br /> • Driveway must meet width/height requirements within 60 days of permit issuance date. <br /> **TOWN/UDC PERMITS MAY BE REQUIRED. OWNER IS RESPONSIBLE FOR CONTACTING THE TOWN FOR MORE <br /> INFORMATION. <br /> **THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> You (owner) are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <br /> Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of <br /> construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources wetlands <br /> identification web page or contact a Department of Natural Resources service center. <br /> I (owner) declare that this application (including any accompanying drawings and plans) has been examined by me and to the best <br /> of my knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained in this application (including any accompanying drawings and plans) and I further declare that I recognize <br /> that this information provided will be relied upon by Burnett County in determining whether to issue a permit. I further accept all <br /> liability that may be a result of Burnett County relying on the information I am providing in this application. I acknowledge that I <br /> will abide by all private/public covenants, restrictions, leases and easements which may apply to this parcel. I agree to permit <br /> county officials charged with administrating county ordinances or other authorized persons to have access to the above-described <br /> premises at any reasonable time for the purpose of inspection. <br /> ---ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE--- <br /> OWNER'S SIGNATURE:__LK V,)]i W1�C' 3✓v "I <br /> (DATE) <br /> Property Owner is required to sign and date this application. <br /> SUBMIT COMPLETED APPLICATION,MAPS,PLANS AND FEE TO: <br /> BURNETT COUNTY ZONING <br /> 7410 COUNTY ROAD K,#102 <br /> SIREN,WI 54872 <br /> APPLICATIONS WILL BE ACCEPTED VIA USPS,ANY STANDARD COURIER, OR IN PERSON. PARTIAL OR INCOMPLETE <br /> APPLICATIONS WILL BE RETURNED TO THE APPLICANT. <br /> NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br /> ONLY CHECK,MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br /> AT THIS TIME. MAKE CHECK PAYABLE TO: BURNETT COUNTY ZONING <br /> Please call the Zoning Office if you have questions. 715-349-2138 <br /> Burnett County,WI ordinances can be found at: http://www.burnetteounty.com/index.aspx?NID=415 <br /> See Burnett County Ordinance for definition of on-premise,off-premise and directional signs. <br /> Page 3 of 4 <br /> Burnett County,WI Sign Application—Rev 3/2016 <br />