2013/07/30 - LAND USE - LUP - Other

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i Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning AdministratorEL 3 APPLICATION FOR LAND USE PERMITS = L OWNER rl(I�A2K ALI $cro At [PI(A/(.- TELEPHONE 763_ y2o-2E�6 o MAILING ADDRESS �47'75Z 3+,sS lid{C I��(/��/V'�pl�/F(� (,��Ljr�V� MIV CSS/3—rY�/�i < PROPERTY ADDRESS ZsSsro WE31 pti." RI✓r1 ISD D&OVi{� ti 77✓3J o c LEGAL DESCRIPTION kfbrCc 04,,S Cor 1b /4 /yy J/Vr Pv OVTCo T5 / 12- 1 a —1 TYPEOFPERMIT(S): SINGLE-FAMILY DWELLING ADDITION ❑ DECKO GARAGE/ACCESSORY STRUCTURE BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS O FILLING/GRADING O CAMPING UNIT❑ COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE CI STRUCTURE/ADDITION USE: Cbt1fti GR2 A( t (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: MOMI o.^+n -2 - SeLP r O A PLOT PLAN MUST BE PROVIDED ON AN 845 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS 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 r BUILDINGS/STRUCTURES3(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, G7 2 AND INDICATE NORTH (N). J l 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) l TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK (01 OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. I c 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK (ST)AND DR I NFIELD (DF),AND ALL DISTANCES TBUILDINGS, ROADS, LAKE, LOT LINES. 1— _ 41) 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO GRADED FILLED. 6. PI SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLa ANS MUST BE SIGNED AND DATED BY THE OWNER. d 1 NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. IJ THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: UII L�I� rr. 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. W 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3, NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. 9j 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. 7. gl anC,n n: o9 ^ x3 § SIF 1 declare that this implication(Including an accompanyingschedule has been examined b me and to the best of m a o e 3 �_ 3 m= '- p 9 Y ) Y Y 3 J __ Information and belief It IS true,correct and complete. 1 acknowledge Nat I am responsible for the detail and accuracy of all —] Information Ia m prod In His illbe application upon(includingby C linty ofa urng t Wd,colns and I further declare that 1 recognize mihat MIs = _ Information I am providing will be relied upon by[he County o!Burnett Wlxonsln In determining whether to Issue a pertnl[. 1 e,2 = Z further accept all liability that may be a result of the County of Bumett relying on this Information I am providing In this $ a a?' _"' S applicetlon. 1 agree to pommit county oBklals charged with administrating county ordinances or other authomed person to have _ =�J c 8: 8 access to the above-described premis at any reasonable Pme for a purpose of InspeCtlOn. ° E OWNERS SIGNATURE / 3d'VZOl3 I/I�-Qp}�InIII''M �3 R ZONING ADMINISTRATOR_ �� Fn) . � L l! D — — r TOWNSHIP PERMITS MAY BE REQUIRED JUN 21 2013 . .. - THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF I NCE - 8 GNSI" 6"�Ni3 GC, IF BURNETT COUNTY ZONING