2008/07/24 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS 14. WW1 n OWNER-10 lam I / n ehnljl_()pJV6. TELEPHONE -7ja-C - �2�1 / d MAILING ADDRESS J �1 J l0 6 I J��-l�D I � PROPERTY ADDRESS .is 0- n o 2-39-/'/-/S-S `- LEGAL DESCRIPTION L' �U Lp C`O�+/�E(`B}^� GSU �07�'/, �S��i^..-/07 o tom/ Ly Ysf 1y ..,)5.�.•i�Y� rF .V TYPE OF PERMrr(S): SIr4GLE-FAMILY DWELLING ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE 0 BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 S' STRUCTURE/ADDITION USE: - c (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: n O � A PLOT PLAN MUST BE PROVIDED ON AN 8 1/1 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o_ WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) 0 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW M w 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, I p AND INDICATE NORTH (N). cc 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S) TO ALL LOT LINES, (B) BUILDING(S) Sj TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S) TO THE ORDINARY HIGH WATER MARK U� (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. v, fl` 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. W 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE o PLANS MUST BE SIGNED AND DATED BY THE OWNER. II NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN y NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. N 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 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. 7. 9nnnn > p T o R R o a r� o 1 declare that this application(Including any accompanying schedule)has been examined by me and to the best of my0 ,�� . ° :. 0, 9 ? qo knowledge and belief K 32.Is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of all El W m 2. 2 a information contained in this application(Including any accompanying schedule)and 1 further declare that I recognize that this ,� -. o c m N information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I g a v 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 have n C' o o S o Eil access to the above-described premises ny reasonable time for a purpose of I pection. o� ZOO � n 3 2y y o p C o o OWNER'S SIGNATURE / �/7/ fD ' a n � do � ng � . ' (date) a o F3 0 ZONING ADMINISTRATOR Jim 1ar)1 G /� a y w' TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N N o U S 0 0 0 0