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ADDITIONAL PROVISIONS <br /> • Rema'. ;nr uttmss, f tees and•re =1'.,n tt well es filling and grading are re4rr:aec within the s orciinc area Reg:33rd <br /> 4trd <br /> shoreline arca is all arca tr.+m the OHM to 50 ft from the OHWM landward. Contact the Land Services Department prior :v <br /> cutting any chorctinc:revs:rod vegetation <br /> • No structures are allowed within any scthack,unless specifically permitted. <br /> • Driveway must meet..vidthtseight requirements within 60 days of permit issuance dutc. <br /> • Accessory structure'garage permits allow for private residential storage only Not to be ranted or tried for human habitation. <br /> • TOWN/11 DC PERMITS MAY BE I4KQI IRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS <br /> RESPONSIBLE FOR CONTACTING THEIR TOWN FOR MORE INFORMATION. <br /> • THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE.ONE EXTENSION MAY BE GRANTED. <br /> • THIS APPLICATION CONS Ii 1UTES NOTICE TILiT ALL IMPROVEMENTS ARE SUBJECT ro ACCESS ANDIOR <br /> REVIEW BY THE LOCAL MLNIC?.UJTY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT <br /> You(owner) arc responsible for complying with state and federal laws concerning ,.onstiuction near or on wetlands, Niece, and streams. <br /> Wetlands that arc not associated with open water can be difficult to identify. Puilun:to comply may result in removal or modification of <br /> cortatucticin that violates the law or other penalties or costs. For mare information visit the Department of Natant: Rcaourem wetlands <br /> :dentiftwtiuc web rage of conn a De7arsnent of Nc.'jsral Resources service center <br /> I(owner)declare that this application(including any accompanying drawings and plans)has beep examined by me,and to the best of <br /> my knowledge :and beiirf it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained to that application (including any accompanying drawings and pians), and i further declare that I recognize <br /> that this iatortrutun provided will be relied upon by ISurneet County in determining whether or not to issue a permit. I ac.rpt all <br /> liability that may be a result of Burnett County relying on the information I am providing in this application. 1 acknowledst:that I <br /> will abide by all private/public covenants,restrictions,leases and easements which may apply to this parcel 1 agree to permit county <br /> officials charged with adwinstrating county ordinances or other authorized persons to have access to the above-described premises <br /> at any reasonable time for the purpose of inspection. <br /> --ADDmoWLL COND.1DcTS FROM OWNER ALLOWED DERE— <br /> OWNER'S SIGNATURE: G' -�'. ' 7- n <br /> (DATE) <br /> repery Vw^er is required to sign:and deigns application. <br /> SUBMIT COMPLETED APPLICATION,MAPS,PLANS AND FEE TO: <br /> BURNETT COUNTY LAND SERVICES <br /> 7410 COUNTY ROAD K.11120 <br /> SIREN,WI 54872 <br /> APPLICATIONS W iLL BE ACCEPTED VIA USPS,ANY STANDARD COURIER,OR IN PERSON. PARTIAL OR INCON Lk 1E <br /> APPLICATIONS WILL BE RETURNED TO TILE APPLICANT.NO EMAIL OR F,AX APPLICATIONS WiLL BE ACCEP I E:) <br /> ONLY CHECK.MONEY ORDER OR CASH PAYMENT WiLL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEP l'ED <br /> AT THIS TIME, PLEASE,MAKE CHECK PAYABLE TO: BURNETT COUJ4 FY LA'D SI R <br /> Please call the Land Services Department if you hew questions. 715-349-2109 <br /> Burnett County,WI ordtrances can be found at: hop:. ww,c.burtac•ttckpois carnianrte ,;i s!N11)-1043 <br /> P3be 3 of 5 <br /> Burnett County. \41 Land Use Application - Rev 0512022 <br />