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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 /> OH W\1 to 50 ft from the OH W'M. 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/LIDC 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 1 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. 1 further accept all <br /> liability that may be a result of Burnett County relying on the information 1 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 /> count 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 /> ADDII'lUNAI COMNIENI'S I'ROM OWNLIt.ALLOWI'D IIL.RI'--- <br /> OWNER'SSICNATURE: _ /)9// <br /> (DATE) <br /> Property Owner is required to sign and date this application. <br /> SUBMIT COMPLETED APPL.ICAT ION, MAPS, PLANS AND FEE TO: <br /> BURNF I COUNTY ZONING <br /> 7410 ('OI;N FY ROAD K,#102 <br /> SIRF`v. v',! 54872 <br /> APPLICATIONS WILL. B F A('CL:I'!'P.D VIA USPS, ANY SFANDARD COURIER,OR IN PERSON. PARTIAL OR INCOMPLETE <br /> APPLICATIONS WILI, BY: R1.1 ( RN H) I O THE APPLICANT. <br /> NO EMAIL OR FAX APPLIC'A"I-IONS \FILL BI;: ACCEPTED. <br /> ONLY CHECK, !MONEY ORDER OR CASH PAYMENT WILL BE ACCPETF.D. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br /> ATTHIS 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: littp://www.buriiettcounty.com/index.asi)x?NID=415 <br /> See Burnett County Ordinance for definition of on-premise, off-premise and directional signs. <br /> Page 3 of <br /> Burnett County, WI Sign Application — Rev 1/2017 <br />