2009/06/03 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS w OWNER 'Ile '..// a / 1?Nr N 1\..J TELEPHONE s J MAILING ADDRESS > � I o ?�2 S 3rcl de, el el73fo 1 ` \ PROPERTY ADDRESS y�/J /01n Ir W ti pS�C Y LEGAL DESCRIPTION Lr CSm va' sec-7 .ora zq T"Oti 'V`o ,lea e is Lot? 03 TYPE OF PEIWIT(S): SINGLE-FAMILY DWELLING ADDITION ❑ DECK❑ GARAGE/ACCESSORY STRUCNRE)C BUNKHOUSE 0 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT[I �-^� 5 COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ r G STRUCTURE/ADDITION USE: .: (Home/Cabin; Comme�1 al Business; Bedroom; Deck; etc) o BUILDING CONTRACTOR: L•. 'i Qv m S - W P ; f:C u CA;eN W � W � SWII A PLOT PLAN MUST BE PROVIDED ON AN 8 Ya X11 SHEET OF PAPER, ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C N WILL BE RETURNED. �.. DIRECTIONS FOR PLOT PLAN DRAWING: (ARTAL OR TOP VIEW) ,�• 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m a O I 6 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW v c BUILDINGS/STRUCTURES (NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, v AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) 5 �'v TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w5" 4. SHOW THEELOCATION OFnTHE RRIVER AND WETLAND WELL(W)SEPTIC TANK(ST)AND DRAINFIELD(D)I AND ALL DISTANCES d Q Q TO BUILDINGS, ROADS, LAKE, LOT LINES. S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE \ k PLANS MUST BE SIGNED AND DATED BY THE OWNER. (v I� o qj (� �' NOTE: NG/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDS `I NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: lV_I C 61 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. r? z a Qi 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. F 70 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER O SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/ST v NOT TO BE USED FOR HUMAN HABITATION. TORAGE ONLY. 6' 1 7. z � a000 > ro I declare that this application(Including any accompanying knowledge and belief k Is true, Iad schedule)has been ermined 3 n OF correct and complete. I adahowkdge that I am by me and to la best of accuracy B 9 � c � 5 Information I am Prov In this application upon udl a e/or the detail and ountm of all 9 a Q a.I- = `" 00 IMormatlon I am providing will De welled u � nY acrarrhpanykg sdheduk)and I futlher declare that I reco9rhhe Mat Ma; n m e'� Pon by the County of Burnet Wisconsin In determiningpenra, I furtiher accept all liability that may be a resole of Me County of aumelt relying on this �m�e a 2'a y aPpliratlon. 1 agree to Permit county officials du Information I am providing In MIs S n n ua v : ro access to Me above-desc ibed aged bleb time or the pp mwky ordinances or other aWhorbed person to have R- o N h S tro" prem s et any reasonable thne for the purpose of inspection. OWNER'S SIGNATURE {/st.i J�� G 7 6 R 6 g$0 8 8 y T (date) a rna�`mnmw� 0 ZONING ADMINISTRATOR ��YY� �Z G�l(CQj1 05. 5'� �k TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE C�i �eaM�� " lei ✓�iGl�eG� ia� 6i1 � t. 8/oC'Jr) Vr U