2014/05/13 - LAND USE - LUP - Other

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ON COMPUTER/SC ANNfM _ Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator - I� APPLICATION FOR LAND USE PERMITS S OWNER /ITELEPHONE CL(C - —Sa15d. TI\�5 TELE� y ) MAILING ADDRESS`�� PROPERTY ADDRESS I�GAL DESC�RI�PTIO�N \ ��s �AMILY D&C,'lID_+1a pe4SY�i� �tD 1M'k.] CLI_ WC�,e� TYPE OF PERMrt(5): SINGLE-FAMILY DWELLING 63' AD (TION ❑ DECK ❑ GARAGE/ACC�SSOR STRUCTURE ❑ BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING Cl CAMPING UNIT 0 COMMERCIAL BUILDINGElCOMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 n STRUCTURE/ADDITION USE: i'I7ttYP_ z -----` -- -- -(Home/Cabin; Commereaf Bustness; Bedroom;'Deck;'etc:)-- BUILDING CONTRACTOR: AlW (5'1 InUn r � A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) r _ 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 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, CO AND INDICATE NORTH (N). \ a cr 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) - TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S = 1 (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. m 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF), AND ALL DISTANCES y T 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 PLANS MUST BE SIGNED AND DATED BY THE OWNER. 1 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: _ 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60A DAYS OF PERMIT. r, z __ 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. `4.NO'GRADINGSTRUCTU ES SH INCLUDING RETAINING WALLS, ETC., AL UNLESS SPECIFICALLY PERMITTED.WA - - 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER Zz SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USEDEDHU FOR HUMAN HABITATION. 6. 7. gF >[. nrC c9 ' p333E � nZ 33 ?S-_, n n I declare that this aDDIt Is n(Including any acme, I ac howledschedule)has been examined e f me and to Me best of cy - o ,p P - knowledge and belief It Is true,correct and mining a 1 acknowledge Mat I ale responsible for Me re M and accuracy of all Information contained In thisapplicationbe rallied upon by any accompanying t Wisconsin and L further ng whether her I recognize Mat MIs > x Information I am providing will be relied upon by Me County of Burnett relying n In denformang I am providing to Issue a permit I further accion. I all liability p Mat may be a result of charged County of Bumex retying county Mis antes or o I r a ftonizng Ia Mis �+ 5 application.to I agree to pried countyofficialsat an reasonable ble ade for the purpose county ordinances or other aumoaxM person to have p g [ access to Me above-descrlbetl Premises a[any reasonable time for the purpose of Inspection. ¢ OWNER'S SIGNATURE / f " - _ _ p ii 8aUL511VL � '' x z ZONING ADMINISTRATOR_ — rte/ _ X _ to NAR 7-2014 TOWNSHIP PER ITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUU1WRNMLOU a '= ZONING