2012/05/31 - LAND USE - LUP - Other

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F z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g 0 APPLICATION FOR LAND USE PERMITS OWNERy TELEPHONE ; a ion an C11 1 \C)Ude X1.5 418'eto3 d dell '71x3-$43-835(0 MAILING ADDRES w1L ^l 1 5—g to � n� ,�n/�a J�irPn t<IS syc�� `/ vl PROPERTY ADDRESS Ll y �s M t d to+ n d 5 rfn U»—5,1 Ss 7 a LEGAL DESCRIPTION TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ CCESSORY STRUCTURE 0 BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ o 0 COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ STRUCTURE/ADDITION USE: &ca fA e 93 'Z (Home/Cabin; GQjnmercal Business; Bedroom; Deck; etc.) 1�`Nl o BUILDING CONTRACTOR: `3+w lhornpluq n 0 A PLOT PLAN MUST BE PROVIDED ON AN B 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O o WILL BE RETURNED. c DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. c 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW BUILDINGS/STRUCTURES (NE), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, O S 3 AND INDICATE NORTH (N). N z 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) C °> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S) TO THE ORDINARY HIGH WATER MARKCP+ 5' d (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. Rp p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)ANO DRAINFIELIi (DF), AND A,LL DISTANCES TO BUILDINGS, ROADS, LAKE, LOT LINES. 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 PLANS MUST BE SIGNED AND DATED BY THE OWNER. � I NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN \ y NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I r. ,ISL/—vV 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n Z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. y 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER d SETBACK AREA. lW 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. 7. ° 3� aCro+'1 Wiz ; Sa ' I declare that this application . on(Including any accompanying schedule)has been examined by me and to the best of my 3 0 � R 2". knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all a m e. R. rn : y Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this v e.> a m N Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I A g a v : b further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree to permit county officials charged with administrating county ordinances or other authorized penton to have W0g access to the above-described premises at any reasonable time for the purpose of Inspection. 6 A 8 g 8 a $ow o o H OWNER'S SIGNATURE I nn onsovorn) �° grAao =' R = z = P ' ZONING ADMINISTRATOR MAY 17 2012 OWNSHIP PERMITS MAY BE REQUIRED BURN ? THIS PERMIT SHALL EXPIRE /ONE YEAR FROM DATE OF IIISSUAN��OOUNN N. ��`^ ArlCc �✓ (2,,q'J� S�pwiv I� ;5:1: �N/r�/!v U $ 0 0 0 $