2011/11/16 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g z APPLICATION FOR LAND USE PERMITS s y I OWNER Mdrz-iLy ,� TELEPHONE 7 O MAILING ADDRESS "' O y ]:& 57 , 111ele-_7W FiEL_/) Al 5,5-05- 7 PROPERTY ADDRESS , � �p ?'-7 0/5 Clew SeY 0 LEGAL DESCRIPTION 15 �I� N LLL o TYPE OF PERMIT(S). SINGLE-FAMILY DWELLING 1$13 ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ v, v BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ c '% STRUCTURE/ADDITION USE: ! L z (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) °Q . BUILDING CONTRACTOR: P_1U61L5 !J�!s?� A WILL BE RETURNED.PLOT PLAN MUST BE PROVIDED ON AN 8 1/2X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS z o O I^ ry DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) r) 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. r_ 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, c AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) c ° TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK R. I Q (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. O 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES TO BUILDINGS, ROADS, LAKE, LOT LINES. _ W 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 9.J 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE -. o 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 '( ..I �,, U1 a NEEDED. CA oQ o THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n Y61 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. N O 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 7' O 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. \ S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. bduck Avelaip. of 87.50 Oee-E W".. j*AW Owe � 44 Deck l e © 91.00 � 7. " 7banncc� aob y n 3 3 v — I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 c = =R °, .°� w knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all g, m d ' q Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this .^° E. > > M ti y Information I am providing will be relied upon by the County of Bumett Wlsaonsln In determining whether to Issue a permit. I further accept all liability that may be a result of the County of Bumett relying on this Information I am providing In this K a application. I agree to permit county a charged with administrating county ordinances or other authorized person to have access to the above-described premises atat any y reasonable time for theu p rpose of Inspection. to c > o o N o o > OWNER'S SIGNATURE 1 o > (date) im = O ZONING ADMINISTRATOR (l'J7 ac : w,rd F7 Fn TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE vi O O p O p