2011/03/08 - LAND USE - LUP - Other

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C R Z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator cr ° APPLICATION FOR LAND USE PERMITS U) � C OWNER (1 ( �,b GSk,l TELEPHONE lJ �I t o MAILING ADDRESS R 39Cj J«a f LN Cc,-Ii,-3, PROPERTY ADDRESS _ 2cacos Prime w \\ Rc4 �u��M w I S9g3o 0 = LEGAL DESCRIPTION r Fl 0 TYPE OF PERMITS): SINGLE-FAMILY DWELLING 0 ADDITION DECK 0 GARAGE/ACCESSORY STRUCTURE 0 -. BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 a v COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o STRUCTURE/ADDITION USE: C--t��it h h I J- Iyl,, `) I I V16'�2. ADD M add;{-I 0 (Home/Cabin; Commercial Business; Bedroom; cpk; etc.) BUILDING CONTRACTOR: ��'� ��5a'+i>c-�-ic� ��L 1 66Y.330p S 000 er O � A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o U WILL BE RETURNED. � C DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) in c 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 �°- BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, E AND INDICATE NORTH (N). N Z 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) 0 ° 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 TO BUILDINGS, ROADS, LAKE, LOT LINES, 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE o PLANS MUST BE SIGNED AND DATED BY THE OWNER. Xl NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN NEEDED. O THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ,- O 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 6 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. (J 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 TO BE USED FOR HUMAN HABITATION. 6. OVA L �arcl CooK/ wJCQ 7, annnnaoro 3 n 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 0,. R ^ o w' knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detall and accuracy of all p� m ! y Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this v c,9 D to information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I a further accept all liability that may be a result of the County of Burnett relying on this Information I am providing in this application. I agree to permit county officials charged with administrating county ordinances or other authorized person to haveo '. o o ,r, access to the above-described premises any reasonabl ime for the purpose of Inspection. mc o 0 N o y rye ' . 0. 0 O q n iia �� OWNER'S SIGNATURE /��• g n ,n Dc.m my (date) ZONING ADMINISTRATOR TOWNSHIP PERMITS MAY BE REQUIRED a "° THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE '=N« H � � 80000 Peoni4 4 de avx t tcd to MecL -q-/L)