2011/04/28 - LAND USE - LUP - Other

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� z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a APPLICATION FOR LAND USE PERMITS Z OWNER 04'wz rL- T 0 EsTELEPHONE MAILING ADDRESS .. 36 iY/N b PROPERTY ADDRESS a83�� , 8R5S <sx� RD ,DA/vacv?sv Gut �'y836 LEGAL DESCRIPTION 5V Ir'yo/R/7W Ac4£S 3.66 Lar 3 csm V/V P //8 C60V Lar 6) � TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE W rn BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ c `° '3_ Nj STRUCTURE/ADDITION USE: y�/ X A $ GARAGE � z (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) 0� BUILDING CONTRACTOR: Dvv /3 -c-,5 7-,#9c#, n O 3 A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o_ WILL BE RETURNED. a DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) M n L }. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. c h SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW03 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, E W AND INDICATE NORTH (N). / N c , 43. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: lA) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) C0 o TO CENTERLINE OF ROAD,) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK E (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND'15) LOT DIMENyJSIONS. C O 14. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANKI(ST)AND DRAINFIELD (DF),AND ALL DISTANCES TO BUILDINGS, ROADS, LAKE, LOT LINES. ti W 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 6` 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE f 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 I W NEEDED. H - THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r- ^� p• -L �'— O 3 V 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. A O 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. L/ 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. C) NOT TO BE USED FOR HUMAN HABITATION. 6. 7. DD b 7 3 3 3 I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my g o,00 9 . 9 q � ?w ' knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all i;. to'w Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this a S.D D 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 .d 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 person to have " m access to the above-described prem as at any reasonable time for the purpose of inspection. 3 > o c o c H OWNER'S SIGNATURE sea - mom ,., _ O rn µ��^ (date) ZONING ADMINISTRATOR I I I 1 1 lAn t I�/ gn TOWNSHIP PERMITS MAY BE REQUIRED O °° THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE Of ISSUANCE o «N o Pe�md � Iee� VhGt�ted +DftA n121esaC1� 4 �5