2006/05/11 - LAND USE - LUP - Other

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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 APPLICATION FOR LAND USE PERMITS 3 r w o ` \ N OWNER 0.J • O T ygs•r O.p TELEPHONE 50 7- 281- 3545 0 _ a m MAILINGADDRESS 1172 Ches+e r Road S.E. ROL. %esi°er_ f+'1t�1 . 55904 r � fI o PROPERTY ADDRESS3o521 nerve La wc_ Tr' '- L t Danbury ��J.1 • S�� 3 0 H- 4e+ 13 Los+ A(.re5 — 10 ISW "I Y7- LEGAL DESCRIPTION(see tax receipt)5 E Yti S ec.+ I I '-rd.�..,t.� 4 1 NL-/4 5 t�+ 30 . fCp A \ DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ® ADDITION ❑ N 0 TYPE OF PERMIT(S): Q FILLINGG//GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a STRUCTURE/ADDITION USE: (Home/Cab ;g tial Business; Bedroom; Deck; etc.) Co m BUILDING CONTRACTOR: 5 G P Gt m v A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81A X 11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. O 0 DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n T 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m p 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m NORTH(N). y o 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S)TO m 4�, 3 CENTERLINE OF ROAD,(C) BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF 1 Z LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. Rj P 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO j O BUILDINGS, ROADS, LAKE,LOT LINES. :E 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 V� 0 MUST BE SIGNED AND DATED BY THE OWNER. F O � NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN �. NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o �" t CONDITIONS OF PERMIT: 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ] ISSUANCE. n, 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. X� 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY 7� PERMITTED. C7 4. NO STRUCTURES, INCLUDING RETAININr:WAI I G FT(-. AI I nwFn WITHIN THF RFnI IIRFn%A/ATPD SETBACK AREA. 5. This structure to be used as private residential garage/storage only. Not to be used for human � a f m 6. n o 3 0 o a n habitation. a m t° ° 05. — Z C N O �. O m T� I declare that this application (including an accompanyingscneoule nas been examined b me and to the best of m A PP (� 9 Y ) Y Y � 4� c � � : C knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m ; N all information contained in this application(including any accompanying schedule)and 1 further declare that I recognizenn�� m m that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- Q) m rn sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am m o providing in this application. I agree to permit county officials charged with a i r' i Cher authorized person to have access to the above described premises at any reas 1 f p o n. m ' 6 N d SIGN HERE (s`igfnare f� owner/or bnuiltling contractor) MAY ?. LIRiB ZONING ADMINISTRATOR �l f(" L�' /Ii ` BURNETT COUNTY O O VNi O VWi (wn N O TOWNSHIP PERMITS MAY BE REQUIRED ZONING THIS-PERMIT HALL EXPIRE ONE YEA FROM D TE OF ISSNANCE �m l I e,-�-le.T rr lzd i o a a uid I �y 95 aP Is-- 4-��