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ADDITIONAL PROVISIONS <br />• Remonl or tuning of rose; aM wocution, in well in filling W grading ore restricted coffin 111: groodioe arcs. Radioed <br />shoreline arca is all area from the OHWM to 50 B ham the OHWM hardwood. Contact di 2001118 O15ee poet to coning my <br />mundane ma and vegetation. <br />I No auecmta are allowed within my aeWaek Whom specifically pernal <br />I Driveway most men u'idrk Might rtyuiemems wiJtin EO days of Formed trounce Side, <br />I gccemory attucuWgange perm show for pnva¢reuicipal swage only. NallabemotWoruWforhumgNMitadon. <br />• TOWNNBC PERMITS MAY BE REQUIRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS <br />RESMNSMLE FOR CONTACTING THEIR TOWN FOR MORE INFORMATION. <br />• THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE. ONE "TENSION MAYBE GRANTED. <br />You (own) are responsible for complying with eon and (Mend Hn concerning cmauumion rear m on neflande, thea. and suuw. <br />Wetlands that are act wareconal with open water end be diRCWt to identify. Failum to tomb may reach an rtmovel or modification of <br />that violate We law r other penaltiesa For information visit We Depm <br />eront of Natural Reformat <br />unlmd <br />identification <br />tion webge paor contact a Defacement of Natural Ramasmzrvice center. <br />1 fawner) declare that this application (including any accompanying dnwingr and plana) has been examined by me, and to the best <br />of my knowledge and belief it is true, round and complete. I aCgnoMMge That 1 am responsible For the detail add accuracy of all <br />information contained in this application (including say accompanying drawings and plans), and I further declare that l rdogmm <br />that this information prmided will be relied upon It Burnes Counter in determining whether or not to Issue a permit. I accept all <br />liability that matbe a result of Burnett Counts relying on the Information 1 am proofs ing in this afternoon. 1 acknowledge that 1 <br />x111 abide by all privatNpublle ememann, restrictions. Inas and easements w'bich mas apply to this perm. 1 agree to Permit <br />county officials thermal with administrating county magnetic; or other authorized persons to have teem to the abuve-deunbed <br />premiss at soy reasonable dare for the put" of trepanation. <br />... ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE— <br />OWNER'S SIGNATURE' LiL '/S-/7 <br />(DATE) <br />Orators, Donau equitd to 1191 ad Are thisaPoliaaman. <br />SUBMIT COMPLETED APPLICATION, MAPS, PLANS AND FEE TO'. <br />BURNETTCOUNfYZONINO <br />74 10 COUNTY ROAD K,#102 <br />SIREN,WI 54872 <br />APPLICATIONS WLLL BE ACCEPTED VIA USPS, ANY STANDARD COURIER OR M PERSON. PARTIAL OR MCOMPLETE <br />APPLICATIONS WILL BE RETURNED TO THE APPLICANT. NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. <br />ONLY CHECK. MONEY ORDER OR CASH PAYMENT WILL BE ACCPEIED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br />ATTHISTBAE.PLEASE. MAKE CHECK PAYABLE TO: BNMETTCOUNTYZONMG <br />PlemcullmeZ jog Once ifyoulavequestoms 715-349-2118 <br />Burned County, Wl Britannia; can be found aD fH,OwwwburnencounrvcoMindeznoaoNlD 15 <br />Page 3 of <br />Burnett County, W I Land Use Application — Rev o3YID17 <br />