2009/05/20 - LAND USE - LUP - Other

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C � p Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a APPLICATION FOR LAND USE PERMITS y C, OWNER Item L /^ - TELEPHONE a 7 l/ _�o> InP (� 7G3 -SZo - 9.170 MAILING ADDRESS ss`1a 9 6 700 Rea r,4 Aye- N. &aAllvx Ct li_e i MK. nPPERTY� AD2E55 �7 r .�/oo ! 1-4scff ZaKe Ad 7OW,,,jA4 or /1ASk 74 Gf �Lurs, `. L GA(,,DESC�tPTION L o f� e7 Cert Sur N Me D jh /[�! S/ *AD i .2T _S/ as Ase TYPE OF PERMIT(S): SINGLE-FATLY DWELLING ❑ ADDITION p9 DECK ❑ GA d//ACCESSORY STRUCTURE ❑ (- N �h S BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ J v COMMERCIAL BUILDING ❑ COMMERCIAL AIIDD''ITIIOON ❑ COMMERCIALL ACCESSORY STRUCTURE ❑ STRUCTURE/ADDITION USE: Y L d01 I K O Ytr C�a I YL. (� o (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) y v' BUILDING CONTRACTOR: I D L./ID C ll — COns 1 .5,,4+ A PLOT PLAN MUST BE PROVIDED ON AN 8 Vi X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m j 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW w 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES,AND INDICATE NORTH c 3. SHOW DIMENSIONS IN(FEETOF 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 w' (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST) AND DRAINFIELD (DF),AND ALL DISTANCES O TO BUILDINGS, ROADS, LAKE, LOT LINES. �' w 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 o W 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. L1' THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r -4 F � 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. r� Z a 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. !n 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 0 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER y SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. 7. T D o 0 0 a O ro 3 3 3 I tleclare 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 1 am responsible for the detail and accuracy of all c m `= w EL a y Information contained In this application(Including any accompanying schedule)and 1 further declare that I recognize that this c `: a D m ,'O, Information 1 am providing will be relied upon by the County of Burned Wisconsin In determining whether to Issue a permit. I ?w= .ay further accept all liability that may be a result of the County of Burned:relying on this Information 1 am providing In this Q c application. I agree to permit county of vials charged with administrating county ordinances or other authorized person to have � d.7 0 8 S o r access to the above-tlre0 esc ibed promises at any reasonable time for the purpose of Inspection. ' m nooiw„ o � a OWNER'S SIGNATURE ^ y, y a m s rn m C Ej ZONING ADMINISTRATOR 'f 1 r 1 Oy. x a TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 5--d-0 c5 � � 00000