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w,nca wumcy t4iu)Bung Kokto n, no. LUZ, DYm, w{ p " ull"of coning AOIIJInISU-dMr u' y <br /> APPLICATION FOR LAND USE PER <br /> OWNERMS S 4 <br /> T �/1 ! .' y� Le(�—�(bsq <br /> L TI O I JI7 TELEPHONE <br /> MAI Ng-.ADD ESS I - <br /> _66 St. A1. OOK /'K His FAN s5o8a= <br /> P OPER AODRES <br /> �� c�; n Lan�el' K;nG Qr.( Webs}e( N/S 5y8g3 g T"ls0 <br /> LEGAL DESCRIPTION O' i SBhdn 29 rdanshrp yonl.,x�9 e Igo tom, 'own o ¢K.n ume ty, _ <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ADDITION 0 DECK D GARAGE/ACCESSORY STRUCTURE-0 <br /> BUNKHOUSE 0 59.692(IV)GAZEBO D STAIRSX FILLING/GRADING D CAMPING UNIT ❑ IC <br /> HFi((yi de lin <br /> COMMERCIAL BUILDING D COMMERCIAL ADDITION 0 .COMMERCIAL ACCESSORY STRUCTURED $ , <br /> STRUCTURE/ADDITION USE: T-I (eTY1' aeee55 to hi1151de ��L L, e <br /> (Home/Cabin; ommerGal Business; Bedroom; Deck; etc.) C��CQ,jJ�V•Ijj <br /> BUILDING CONTRACTOR: Jill <br /> n <br /> 3 _ <br /> A PLOT PLAN MUST BE PROVIDED ON AN 0 K X11 SHEET OF PAPER. ANY INCOMPLETE.OR ILLEGIBLE PLOT PLANS C o <br /> WILL BE RETURNED. T. ffi <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. G - <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (ES)AND ALL NEW to <br /> BUILDINGS/STRUCTURES INS), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, �. b <br /> AND INDICATE NORTH (N). \ 222yyy111 <br /> 3. SNOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) fj <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM) OF-LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (0) LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD(DF), AND ALL DISTANCES j <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. a <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE S <br /> ' PLANS MUST BE SIGNED AND DATED BY THE OWNER. I _S C� <br /> NOTE: BUILDiNG/SIRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED.. <br /> THIS PERMIT 1S SUBJECT TO ALL CONDITIONS LISTED BELOW: . <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. L <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. ` <br /> S. ACCESSORY SED FOR HUMAN HA PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> 6. -NOT-T__ OBE USED FOR HUMAN HABITATION, <br /> 7. S A7Tq'Lf(� Lo�✓D/�lvn 5 L>yPED Sy�AiED ;� G D 1 F > n,n n cs> Fr <br /> 1 declare that Nb aPPllmpon(mtluEinp IMY aaomvaLryhp sme,TI has dem examined by me and m the best of my <br /> knowledge and delle)R Is me,cdnxeQ and o nplam.-1 acbUvhdge pat I am respaalble for tlro Getall and amrary sf ep E( Ee, <br /> mf%nrat,Tn conmined In nib aDDllmpan(Including a"amampanybV aclrrmer adule)and I hdeclare that 1 rampNze of all � c <br /> INormation I am pmvldmg Mil W raked upon by me County of map Wbmnsin In dammtInIng whamey m Im u t a permit 1 <br /> further a=pt all Ilabillty that may M a result 0 the County of retylrp m thb INormatlm 1 em preNdtrp In this <br /> 6 <br /> eDDllmtlod 1 prae m owns oRitlab ciarged MUT a Inlstratln munry mtllnanma m other suthaped panni w lava j l <br /> amus m the above-d Ft pk mr ar Impectbn. s <br /> OWNERS SIGNATl7RE— <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED pp����pp <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUMNETT COUNT f <br /> ZONINGwa�- Q <br />