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

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- Z . Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS = OWNER / � � l ��M fD � TELEPHONE �l�� '7�p II Fi�� (� �/ V � �/r A I J // O VV�(��j / � L MAILING ADDRESS 3SC � C �I� R/'^zG /✓ICU UU lh�a// �y�)Y �'� '^'/�) _ �. p \\ PROPERTY ADDRESS � /�[` ��,� /�� /Oh I n �h G o/ % ��1, �o o NNN� LEGAL DESCRiPT10N -/J Q L ✓iii ��<J�/`h - /� �- - l3 � y T y� n�` t�lr � i; s ,E �a ,l��h SINGLE FAMILY DWELLING ❑ GARAGFJACCESSORV SiRUCiURE� ADDITION ❑ STAIRS ❑ - TYPE OF PERMR(B): FILLING/GRADING❑ CAMPING UNIT❑ BUNKHOUSE❑ 59.692(1V)GAZEBO ❑ DECK ❑ - STRUCTURE/ADDITION USE: �G�AS/6 :' 0 3 U (Home/Cabi m/menial B�u}siness; Be oom; DDeck; e[cJ /,I/J _ � '�\ BUILDING CONTRACTOR: U L✓G G6%r�/ ��J � �� 7 / J6�� ll" A PLOT PLAN MUST BE PROVIDED ON AN 8 Va X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS x � WILL BE RETURNED. - - DIRECTIONS FOR PLOT PLAN DRAWING: (AR[AL OR TOP VIEW) - I. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE - 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCNRES(EB)AND ALL NEW - _ n BUILDINGS/STRUCTURES(NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, _ _ AND INDICATE NORTH(N). � � 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDINGS) � � m ; Z TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMENT(5)TO THE ORDINARY HIGH WATER MARK ��CiCiCi��j' _ i (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. - 4. SHOW THE LOCATION OF THE WELL(W),SEPRC TANK(ST)AND GRAINFIELD(DF),AND ALL DISTANCES � p TO BUILDINGS,ROADS, LAKE, LOT LINES. i INDICATE IF A WALKOIfT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. C 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHRECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE PLANS MUST BE SIGNED AND DATED BV THE OWNER. � y t NOTE: BUILDING/STRUCNRE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN Cy ppp� �� y NEEDED. �`j SS `y _ THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: � 1 � C a 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN li0 DAYS OF PERMff. (� A 2. REMOVAL OR ClJT1TNG OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. � (; � ? C 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. a w 4. NO STAUCNRES, INCLUDING RETAINING WALLS, ETC,ALLOWED WITHIN THE REQUIRED WATER � _ � SETBACK AREA. /I \\II i�� 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENRAL GARAGE/STORAGE ONLY. � Sl' {� NOT TO BE USED FOR HUMAN HABITATION. U 6. ]. f Itle<lare Ma[Mis apPlira[ion nclutlin acmm scM1etl le M1as been examinetl by me antl[o the bert of my knowledge ^ �� _ = p and belief it is[rue,correctantl wmplete. [acknowledge Ma[Iam responsible fortM1e detail antl accuracy afall information ' � �` _ � �? 3 conUinetl in[M1is applica[ion(indutling any accompanying ttM1edule)antllturther declare lM1a[[recagnize tM1at[M1is informa[ionl '- � '�� mpmvitlinq will berelie0 upon by tM1e County of Burnett Wisconsin in determining wM1eMer fR iuuea permit (further accept all _ liability Nat may be a result of[he County of Burnett relying on(M1is in(armation 1 am pmvitlinq in this application. I agree fo permit - Y county Rffcials cM1argetl with atlminirtra[inq wunryortlinances orotM1er au[horixetl person to M1ave access tothe above4euribetl _ � � premises atony reasonable time farlM1e purpose ofi s"yeRian. _ law ^ c [�' �%�c _ N C1 dY� O ' ? = Y OWNER'S SIGNATURE o� F �B ? '3 lm _ n0 ZONING ADMINISTRATOR Z�~ Ir� � `' � TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISS A�E�hFj"f ��?L-(i'I V NST yi�,o��Di-- 13 e^3;4�'ai� .. �.