2011/06/03 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g APPLICATION FOR LAND USE PERMITS < ,u1' OWNER TELEPHONE a A�y��so.✓ �1 6S/- �I,s-his -o MAILING ADDRESS 0 'r/� - A)01W 5530 PROPERTY ADDRESS f,oT/ tI4T0 r✓tr2S�Otr` .�c•3' LEGAL DESCRIPTION T� o20 TYPE OFPERMIT(S): SINGE-FAMILY DWELLINGK ADDITION DECK GARAGE/ACCESSORY STRUCTURE w BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ COMMERCIAL BUILDING ❑ COMMMERCIAL ADDITION 11COMMERCIAL ACCESSORY STRUCTURE ❑ STRUCTURE( DDITION USE: h1<e '1 — (Hom abin; Commercial Business; Bedroom; Deck; etc.) P Au BUILDING CONTRACTOR: rJD 0o(.11 nn C)--Z v A PLOT PLAN MUST BE PROVIDED ON AN 8 rh X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o _ WILL BE RETURNED. ,� — DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m °- 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. c 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW tNn o BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, .a AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S) TO ALL LOT LINES, (B) BUILDINGS) 0 o (� TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S) TO THE ORDINARY HIGH WATER MARK (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p v yy 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES - O 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 $ G PLANS MUST BE SIGNED AND DATED BY THE OWNER. _ O NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ..1 17NEEDED. CrI THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: l.. Cr d F G S 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. i 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER 4) SETBACK AREA. o 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR//--HUMAN AGITATION. p 6. Z=`XI�h� dGCIPF.,L�� i�MgetiSV 7. /-;0n L✓! r ( / ��1 U� �f7lS //r� LIG/ i ;u 0 r 0 o n c qv n m 3 3 3 n a n l+1 I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information contained In this appllcation(Including any accompanying schedule)and I further declare that 1 recognize that this E. a a m `O Information I am providing will be relied upon by the County of Bumett Wisconsin in determining whether to Issue a permit. I w o. 2 d a further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this = i y w d, N 7 application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have ° d,z o access to the above-described pr ises at any reasonable time for the purpose of inspection. m 2 S w o 3 � °' 9 � o � � � y OWNER'S SIGNATURE �—' —� ,"-_ m a _LA m r,, 0 (date) n v, > -. O d _ ZONING ADMINISTRATOR ellA - ,. TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE ✓ ^N 'R'(0,+4 )e-t4f r✓ha i ted lzj BVbr-rte D Isvn (v __� —