2012/12/07 - LAND USE - LUP - Other

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�Z \ Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator c APPLICATION FOR LAND USE PERMITS �. wN «IJJJ III 5 C rn 6 OWNER mo�-hy + �l MbP��y �CGIYt TELEPHONE .I MAILING ADDRESS 21 -Tgo I o PROPERTY ADDRESS "� 0 1 � 40 � Co u n hA 2�l Do,v, u W T 51+9 30 y LEGAL DESCRIPTION ,� I 1^I_(�t�1 �n^n ---j'/�'I �� /Uyu Jl J GLS I �i V;N TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING)& ADDITION ❑ DECK�- GARAGE/ACCESSORY STRUCTURE) BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ ( n COMMERCIAL BUILDING C COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE❑ STRUCTURE/ADDITION USE: \ pp n (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: �IV QckYLy,n¢Q Cnhls lTA �_�\ f)�� (p T y 1\1 A PLOT PLAN MUST BE PROVIDED ON AN 8'A X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. kkk111 C7 �- DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) C O 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. �y :: 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW o BUILDINGS/STRUCTURES(NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, 11� B AND INDICATE NORTH (N). o11, z 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) 5 41 TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK O (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES S. TO BUILDINGS, ROADS, LAKE,LOT LINES. �7 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. NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. 1 THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: wFr, 111N, 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. d z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. C7 N 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 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. NOT TOO BE USED FOR HU��LA4AN HABITATION. n / /J 6• pll ryp� o�.Uu�e-L�� lNc�aC„�.� Qe--Lrloo�rec)L /n6eJrbe 2!!xeToU 7. yyaa ro y 3 3 3 R a I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 c 2 _ �, ? w knowledge and belle(it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all d P y information contained in this application(including any accompanying schedule)and I further declare that I recognize that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I d ? a = ''t further accept all liability that ma be a result f the County of Burnett relying on this information I am providing in this : '�0 3 .`� N b application. I agree to rrrgt coon tial harped with administrating county ordinances or other authorized person to S ! o o .r, have access to thea e-described pre i a an a ble time for the purpose of inspection. w N W Y OWNER'S SIGNATURE -"'� �/4Z D 6 O F (date) ZEN a� m u o � = Z ZONING ADMINISTRATOR a � a '� 2 SEP 21 2012 ` w 0 n M N ' 6 y TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSU o NETT COUNTY ZONING