Laserfiche WebLink
• Y ' a 3 :7 <br /> qqC-y <br /> -.q ;f. uwy{ r�>{? t fit.. 7 <br /> ar; ADDITIONAL PROVISIONS <br /> Koval at etattnst;ao well sa fipmg end grading are restricted within the shoreline area Restricted <br /> iihatOthp, 1hflw1M40 SO ft fromthe OBWM landward. Contact the Land Services Department prior to <br /> k !S �1,' k°II1e88sJK <br /> • x rep uirements within dt!d ot_pa .i a date. <br /> A :pe nits allow for private residential� �Y storage only. Not to be rented or used for human habitation. <br /> • TOWN/UI)C P$SM!'fS MAY BE REQUIRED'FROM.TOWN MUNICIPALITIES • <br /> . . PROPERTY OWNER IS <br /> RESPONS =UNTACPIItlt;f;ralwR TOWNPC R MORE INBORMATioN.• il <br /> T E ONE YEAR FROM DATE OF ISSUANCE.'ONE EXTENSION MAY BE GRANTED. <br /> • . T IS APPLICATION COlNSU I u a nS NOTICE TIAT ALL VIPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br /> REVIEW BY THE LOCAL MUNICPp,LFFY'S TAX ASSESSOR FOR 1HE PURPOSE OF TAX ASSESSMENT. <br /> • <br /> You(owner)ore responsible for complying with state and f:derallaws non g construction near or on wetlands,lakes,and streams. <br /> Wetlands that are not aasopabed with-aim water can be cli}SCuk toiidenhfy;::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*eb page or coetutxa;bepattmcnt;ofNadual Rosourcat service'center. <br /> t(owner)declare that this application(including any accompanying drawings and plans)has been examined by me,and to the best of <br /> mrlinnerledge and belief it Is true,Correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> Informafloa oo eInediin-:this application(Including any accompanying drawings and plans),and I further declare that I recognize <br /> that.tip inform a'provided will be-relled upon by Burnett County in determining whether or not to issue a permit I accept all <br /> ,'; liability that niay bee 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 /> ADDITIONAL COMMENTS FROWNER ALLOWED HERE- <br /> 1 <br /> '1 <br /> CAMPER'S SIGNATURE: Cei DATE: <br /> 1% — <br /> OWNERS SIGNATURE: ?�—a 11 <br /> M!(leak / +fit is k furor — A/an7h fawr frees t! �,(c. <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 IC,#120 <br /> SIREN,WI 54872 <br /> APPLICATIONS WILL BE ACCEPTED VIA USPS,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 SERVICES <br /> Please call the Land Services Department if you have questions. 715=349 2109 <br /> Burnett County,WI ordinances can be found.ait:Itttp://www.b>srnattteounty.com/index,asps?NID=1043 <br /> Page 3 of 5 <br /> Burnett County,WI Land Use Application—Rev 05/2022 • <br />