2010/04/05 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g APPLICATION FOR LAND USE PERMITS y. OWNER2 n ��1/ rGk a( TELEPHONE 7LJ �r�t� pc �✓70 J MAILING ADDRESS E�(✓o0a W-1 PROPERTY ADDRESS l!/ �2QSQ'1 LCC " pa n 1d,SLnaS vV n LEGAL DESCRIPTION I C; 0 TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ �" w BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS Cl FILLING/GRADING ❑ CAMPING UNIT ❑ I E 9` 2 COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ STRUCTURE/ADDITION USE: �(il,iyll"Ll Y 1�NYIQ 4- ai W!2Q bedrO D/yIS = Lq ,bdrm 6-fij o (Home/CaDin--t,ommercial Business; BeMNdom; Deck; etc.) BUILDING CONTRACTOR: ' Tb I,, / A L C� 4 PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS 0 o WILL BE RETURNED. — DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) � V 1 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. r !" P 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW �% o BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, B AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) ° TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w' O (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS.' l� 4. SHOW THE LOCATION OF THE WELL (W), SEPTIC TANK(ST)AND DRAINFIELD (DF), AND ALL DISTANCES 4 7J TO BUILDINGS, ROADS, LAKE, LOT LINES. - N 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE ,. o `Z PLANS MUST BE SIGNED AND DATED BY THE OWNER. a 0'� O NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 0\ yN l j NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Q 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n c� 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. l� C 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6' flh r�`ty Cuall 70 IJe GLaxr 'Eh s.. 7'S-Fief FYo>r £he ONW� of 61/,(d/4,, 7. S�(� Fe rt T, le >7/acerb Lo„ru erd eL yywf d aver z !c5 (ret Froin 014rdM T o 0 0 YY I declare that this application(including any accompanying schedule)has been examined by me and to the best of my c 0 3 El n o knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all a Information contained In this application(Including any accompanying schedule)and I further declare that I recognze that this Information I am providing will be relled upon by the County of Burned:Wisconsin In determining whether to Issue iPermit. I &R a c= a — further accept all liability that may be a result of the County of Burned:relying on this Information I am providing in this ; v, Vro application. I agree to permit county officials charged with ad�Inlstrdting ounty ordinances or other authorized person to have d,°z 8 0 g access to the above-described premises at my reasons tllSie for the e f I pectIon. o 1�l/,/ OWNER'S SIGNATURE - ��—� = A a a a ... (date) ZONING ADMINISTRATOR 641 Z4, y H 0 w'"^ g TOW HIP PERM MAY BE REQUIRED d THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE Peayri++ Ie' 4up"(OtAto bL-1 fimHE +iKUs 11-aLt-09 � � s000s