2006/10/13 - LAND USE - LUP - Other

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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 G) Z APPLICATION FOR LAND USE PERMITS CD p r N � r OWNER ,� '7' // -7 / /-7/J 457 Rob LI s /G/// F✓C CJ<r� l Nl✓S�V TELEPHONE MAILINGADDRESS �7�0 �J/� f� ASG Y+ /gym /, / n `�rU6 y I p J r m PROPERTYADDRESS t/ S7 2 t`jG f7 en i'o'I �" /P/� I✓ Ts�' o LEGAL DESCRIPTION(see tax receipt) P b &1,1 4,4 t'/ 1� �/O/�' /� a�U P°ZL `� ?) � ; r DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ O TYPE OF PERMIT(S): 'P' C FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a 5 STRUCTURE/ADDITION USE: ' Iy/ o (H Cn; Qommeraal Business; Bedroom; Deck; etc.) y o BUILDING CONTRACTOR: v L1 A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 71 SHEET OF PAPER. ANY INCOMPLETE OR 3 9^ ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n 3 O — m DIRECTIONS FOR PLOT PLAN DRAWING' (AERIAL OR TOP VIEW) 0 n m 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n o A .� 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m �? NORTH(N). c � nO 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m I o CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. Z 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO r o BUILDINGS, ROADS, LAKE, LOT LINES. Q 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS 0 MUST BE SIGNED AND DATED BY THE OWNER. �� £ ) NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o o n1 NEEDED. ^. U r THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. O Z h ,1^ CONDITIONS OF PERMIT: P 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT �� ISSUANCE. 1 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Ck� 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY (J PERMITTED. O 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER 5. OrS TBACK AREA. _ / Ct.rc� pz.r ,; - 60OW-S for p rt ✓a-C r�Sicf. nhk) 3arl 61D�&-Vy. /Vof t +bJbc (.used r h U/h.e[n hct.b)'�lze A m o r D O D 0 10 s. /V T1�017 r m c W 0 M a F m m s3 'nm 9 om CN .`° o Z C o � 3 7. y o 1 p p m I declare that this application (including any accompanying schedule) has been examined by me and to the best of my q knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information contained in this application (Including any accompanying schedule)and I further declare that I recognize m that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am ` W o providing in this application. I agree o permit county officials charged with administering county ordinances or other m '^ authorized person to hav ces t scribed premises at any reasonable time for the purpose of inspection. ' [ SIGN HERE AQ ^ Z n v+ n nature of ow er or buildleg contractor) (date) o ZONING ADMINISTRA OR 1 I ,) r `O 1 L^a V( S V (�ONN W W NO TOWNSHIP PERMITS MAY BE REQUIRED o u o u v o ,TMIS PERIT SHALL EXPIRE ONE YEAR FROM DAT °F ISSUANC m4 le e-r(hT(7.eq' ,-ro