2011/09/20 - LAND USE - LUP - Other

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z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g APPLICATION FOR LAND USE PERMITS W F OWNER —�' M1IE� y� E" � TELEPHONF�S.� MAILING ADDRESS � ��/1 r1r _.��u�U �A�� l( �Bu�� AA • 1 rJslZ � ' PROPERTY ADDRESS GT101 Wfv1.N L Nu CO--CI-- Lill n LEGAL DESCRIPTION GO o TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ,�, 4- BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ }rn� T COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ STRUCTURE/ADDITION USE: o (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) CA)J BUILDING CONTRACTOR: E ILL C1N Si�e� bA1N )P �� G n Z-LLLY 1,7011 A PLOT PLAN MUST BE PROVIDED ON AN 8 1h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C WILL BE RETURNED. � c DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) b rM W p 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW m w 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, J Op P AND INDICATE NORTH (N). ` z 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) O = o TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK A) (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. O p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES (R TO BUILDINGS, ROADS, LAKE, LOT LINES. 0 S. 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 C!1 (1 o PLANS MUST BE SIGNED AND DATED BY THE OWNER. ( J W U NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0- I. -1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. v1 ti z C Il.ZJ 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. h S 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. R1 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER c, SETBACK AREA. 0 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. 0 V I NOT TO BE USED FOR HUMAN HABITATION. 6. �. ? a000 � aro $ 0' S I declare that this application(including any accompanying schedule)has been examined by me and to the best of my a 1'2 knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all °. m RL RL = e : -i Information contained in this application(Including any accompanying schedule)and I further declare that I recognize that this .'° g, o a m Information I am providing will be relled upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I H ?w' further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this "v cin N?'L'N ro application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have access to the above-described oramises at any reasonabl me for the purpose of Inspection. ° d iS5 u+„`^,w r) Ado ooa ^ 'mn OWNER'S SIGNATURE n 65 a '4 Mr o:c v O m c 'Z �1 (date) ZONING ADMINISTRATO C . � c tri TOWNSHIP PERMITS MAY BE REQUIRED A THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE o ^ o Pe,�m f 4-1 10 L�_jo hL4JaoieSaqeSq-a ► I U o00