2009/05/29 - LAND USE - LUP - Other - 33563

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Z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g 3 APPLICATION FOR LAND USE PERMITS y W �Rf K05r 1715 -656 30743 s a OWNER TELEPHONE �P M aAltO Mer v 9/S—lv S(o- S/oBy (n MAILING ADDRESS T V 4/� ✓ V I/.// n ri PROPERTY ADDRESS 4 f ;#s' 401 S, .14 Al e W , S ecTio,t- s Tw}� iso •/6 LEGAL DESCRIPTION / Pe Z SG. ' Sec _s—w, sE s.{' Sem 6 TYPE OF PERMrT(S): SINGLE-FAMILY DW EUJNG❑ ADDITION Q— DECK 0" GARAGE/ACCESSORY STRUCTURE O BUNKHOUSE ❑ 59.692(1V)GAZEBO 11 STAIRS❑ FILLING/GRADING 0 CAMPING UNIT❑ - O COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 r' 0 3 STRUCTURE/ADDrnON USE: c (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: A LAC- J n _ O 1 A PLOT PLAN MUST BE PROVIDED ON AN 8 Ya X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o WILL BE RETURNED. - O 0 n 6 DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) ^p 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, Q) a AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDING(S) o TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S' (OHWM) OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. p ac 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD (DF),AND ALL DISTANCES G TO BUILDINGS, ROADS,LAKE, LOT LINES. 2 w O S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. T 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE o PLANS MUST BE SIGNED AND DATED BY THE OWNER. NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 1 w NEEDED. I(y�,, 0 THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r o I ' 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. X '� 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER I� SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. _ 6. 7. > $ Ls I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my 6 0.02 R ?w knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all m e rred E a: : H Information contained In this appikation(Including any accompanying schedule)and I further declare that I recognize that this 8o iw<: ro Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I ., further accept all liability that may be a result of the County of Burnett retying on this Information I am providing in this ot��O e ;,,N: '_^M r application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have w .7 access to the above-described premises at any reasonable time for the purpose of Inspection. 0 > OWNER'S SIGNATUREn $WO u,M0 date era >o' 6 Z ( ) g8 �� 95e ZONING ADMINISTRATOR TOWNSHIP PERMITS MAY BE REQUIRED n°° THIS PERMIT SHALL EXPIRE ONE YEAR FROM n DATE F ISSUANCE r L /J / IVANOOOOO //T�//n ?- SC� �°9^- NO rc� A-+ Nfrrk ei"4r 4� a-GJ (,