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A fD'TIONA . PROVISIONS <br /> e Removal or cuffing of trees and vegetation,as well as Alin'and grading are restricted within the shoreline area Restricted <br /> shorr�lin. 9trti.is all area rrnt+a ttu.O ?M to 50 ft t'rotn to t.t var'i. Coatnet the f'e' C+zrr i'es D,.p>u!t!Iaent prior to <br /> 4.UILIiAt.,'any <br /> • No structures are allowed within any setback, unless specifically permitted. <br /> e Driveway iririit rr.cci width/height requirements within 60 days of permit issuance date. Cleared width of 20 fi. Cleared height of <br /> 13 ft. See County Ordinance i:iiaptcr 3(1 fot additional driveway requirements. <br /> • Accessory structure/garage permits allow for private residential storage only. Not to be rented or used for human habitation. <br /> • TOWN/UDC PERMIT'S MAY LIE REQUIRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS <br /> Rt'.SPON@fRI.1i. tiflR (YIN'1'At"i'fa[C'i'tts'toTOWN )tilt? Mfl!25' lill+'t)ioM l'1'itl�t- <br /> • 'l'llle,PERMIT SII.Al:1:EXPIRE ONE YEAR FROM HATE OF'ISSUANCE. <br /> • ONE EXTENSION MAY BE GRANTED WITH APPROPRIATE APPLICATION. EXTENSION MUST BE APPLIED <br /> .'ll7l Tilllllll •1`!♦ l7117lyivo A l 01.•l7kil•l•V,s,Ill rll mr, <br /> a 't'HlS APPLICA't'iOtN CONStiTUTM:S NOTICE THAT ALL, IMPROVEMENTS ARE SU13JEC'l"t'O ACCESS AND/OR <br /> REVIEW :3Y THE LOCAL. MUNLCPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <br /> You (owner) ate responsible fo: complying with stale 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 ih^ 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 /> 1 (owner)declare that this Rltliticatinn(including any accompanying drawings and plans)has been examined by me,and to the hest of <br /> my knoveledi,e and belief it Is tt De:, con 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 /> .t (:;:::. f is deter.t iniog whether or not to issue a permit. I accept all <br /> liability that may be a result of Burnett County relying on the inforrination I am providing in lids application. I acknowledge that I <br /> will abide by all privnte/pul)lie covenants,restrictions,leases and easements which may apply to this parcel. I agree to permit county <br /> officials chat gee t.iiii administrating county ornii!.,.l_.eee r..`.i: L.:,•. .. 1. <br /> at any reasonable lime for the purpose of inspection. <br /> --ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE--- <br /> OWNER'S SIGNATURE: di 4/2_1 2 0 Z3 <br /> (DAYE) <br /> Property Owner is required to sia_n and date this arinticatior <br /> SUBMIT COMPiJcFEI)APPIACATiON,MAPS,PLANS AND)11 TO: <br /> i3URNE FT COUN"CY LAND SERVICES <br /> 7410 COUNTY ROAD K,i/l20 <br /> SIREN, WE 51812 <br /> APPI.iCA'I'IONS Wit.i,1W ACCEPTED)VIA 11SI'S,ANY STANDARD COURIER,OR IN PERSON. PARTIAL OP INCOMPL1E'T•E <br /> APPLICATIONS WILL BE RETURNED TO THE APPLICANT.NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br /> ONLY ('III{CK MONLY OL.t)I OR CA 11 PAYMENT Wit:l.Rig ACCPPTi D. CREDITOR DEBIT CARDS ARE NOT ACCEPTED <br /> AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNETC COUNTY LAND SERVICES <br /> Please call the 1.titd Services Department if volt have iritcations.. '115.349-2109 <br /> Burnett County,WI ordinances can be found at: http://www.burnettcounty.com/index.aspx?NID=1043 <br /> Pane 3 of 5 <br /> 129>•10); C; t1 sty, •VI I,1:1,1 Use ;\.1=,1.e.1ta,,;1 Rev 511023 <br />