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ADDITIONAL PROVISIONS <br /> • Removal or cutting of trees and vegetation,as well as filling and grading are restricted within the shoreline area. Restricted <br /> shoreline area is all area from the OHWM to 50 ft from the OHHWM landward. Contact the Land Services Department prior to <br /> cutting any shoreline trees and vegetation. <br /> • No structures are allowed within any setback, unless specifically permitted. <br /> • Driveway must meet width/height requirements within 60 days of permit issuance date. <br /> • Accessory structure/garage permits allow for private residential storage only. Not to be rented or used for human habitation. <br /> • TOWN/UDC PERMITS MAY BE REQUIRED 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 CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br /> REVIEW BY THE LOCAL MUNiCPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <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 rue,and to the best of <br /> my knowledge and belief it is true, correct and complete. I acknowledge that I 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 or not to issue a permit. I accept all <br /> liability that may be a result of Burnett County relying on the information I 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 county <br /> officials charged with administrating 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 /> ---ADDITIONA1.COMMLN'iS FROM OWNER ALLOWED IWU--- <br /> Camper Name: MWt'it. m0v, w,...x1/4,1` Site#: <br /> OWNER'S SIGNATURE: l// It/;/1/4•/ I/ //7 - l;- 2023 <br /> (DATE) <br /> Property Owner is required to sign and date this application, <br /> SUBMIT COMPLETED APPLICATION,MAPS. PLANS AND FEE TO: <br /> BURNETT COUNTY LAND SERVICES <br /> 7410 COUNTY ROAD K,»120 <br /> SIREN, WI 54872 <br /> APPLICATIONS WILL BE ACCEPTED VIA LISPS,ANY STANDARD COURIER,OR IN PERSON. PARTIAL OR INCOMPLETE <br /> APPLICATIONS WILL BE RETURNED TO THE APPLICANT.NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br /> ONLY CHECK,MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br /> AT THIS TIME. PLEASE,MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SIR V I C ES <br /> Please call the Land Services Department if you have questions. 715-349-2109 <br /> Burnett County,WI ordinances can be found at: htta://www.burnetteounty-eom/index.asox?N 11)=1043 <br /> Page 3 of 4 <br /> Burnett County,WI Land Use Application — Rev 12/2020 <br />