2013/04/22 - LAND USE - LUP - Other

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\z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS aV3 - 8/V3 OWNER TELEPHON SfFF�y .2 �ort �3a,1 �, fl�459 — 9g0� (ti 0 MAILING ADDRESS 79,3V C�R7ti 5/ c� �o�g�6ecue rye iL� �nn PROPERTY ADDRESS Ll� // S Vie-r W'l , QA-� ^/,Q '�/J.✓,tJ S�. iP c I" LEGAL DESCRIPTION AalcjG /J �� OhxL.H✓� - �/ L,o/I Za (�,Dv-r Lois rL SeclY IUuap ) 4o JJ TYPE OF PERMIT(5): SINGLE-FAMILY DWELLING ADDITION DECK ❑ GARAGE/ACCESSORY STI CTURED BUNKHOUSE ❑ 59.692(1V)GAZEBO C! STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT 11c COMMERCIAL BUILDING ❑ COMMERCIAL.ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o Q K>D!a[ STRUCTURE/ADDITION USE: Ken w. �<- ✓r ' (Home/Cabin; Commerci I Business; Bedroom; Deck; etc.) f n {{{(((111 BUILDING CONTRACTOR: D A Vf\Jf,5,,,J � S S A PLOT PLAN MUST BE PROVIDED ON AN 8 'A X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS s _ WILL BE RETURNED. OO DIRECTIONS F00.PLOT PIAN DRAWING: (ARIAL OR TOP VIEW) CI _ 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, 3 5 AND INDICATE NORTH (N). 6 c 00 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT TINES, (B) BUILDINGS) w = TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK p I w (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. 1 p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES = TO BUILDINGS, ROADS, LAKE, LOT LINES. 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. Q y W 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLAINS MUST MUST BE SIGNED AND DATED BY THE OWNER. ` NOTE: BURRING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: rrrL ii ip�(�1 I�TWJ� 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. _ 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. I^ 4. NO STRUCTURES,-INCLUDING RETAINING'WALLS, TC,ALLOWED tVITYIN THE REQUIRED WATER 5zo SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. F 6. / I deNare Mat this application(Including any accompanying acbedule)has been examined by me and to Me best of my 3 0 .J 0 _ knowledge and belief It Is true,correct and complete. I acknowledge Mat I am responsible for Me detail and accuracy drag -It _ Informs don contained In this application(Including any amnmpanying schedule)and I further declare Mat I recognire Mat this > > ru InMrmabon I am pmvMing will be Riled upon by the County M Bumett WLsmmM In M mining wM er M Issue a permit. I - - 5 further atttpt all INbllity Mat may be a result of Me County of Bumett relying an this lnfometlon I am poording In this '0 appllcadon. 1 agree M permtt county officials cbarged with administretlng county ordinances or other authorized Person M have _ 0J - access M Me above-desaltRd premises at any reasonable time far Me purpose of Inspection. ° 5 N o n ^,'�',.,^ F 3 'ro > 5��88H OWNER'S SIGNATUREn nrp = 'w UfL}5 E - i ZONING ADMINISTRATOR r m APR 4 2013 N TOWNSHIP P RMIrS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS§Itj -1.COUNTY ZONING