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I (applicant) hereby make application to the Land Use and Information Committee for a Conditional Use Permit <br />A plot plan drawing is required. Plot plan shall be drawn with a scale preferably at 1"=20' or multiples of <br />10'. Scale shall not exceed 1"=50'. Note the scale used on the drawing. Plot plan drawing shall be on letter <br />or legal size paper with North being at the top of the page. (Make sure all items below are shown): <br />G� Property lines, road right-of-ways, and road centerlines including distances to property lines, road right-of-ways and <br />road centerlines for all existing and proposed structures on the parcel <br />l� Show area to used for the proposed Conditional Use <br />U/ All existing uses on parcels adjacent to the parcel for this request <br />9 All existing zoning districts on parcels adjacent to the parcel for this request <br />5t Vegetation proposed to be removed or disturbed (do".0 ) <br />0/1'Ordinary High Water Mark (OHWM) and distances to it from alt existing and proposed structures; must show all <br />/within 200 ft of structures <br />O/ Floodplain and wetland boundaries and distances to them from all existing and proposed structures; must show all <br />within 200 ft of structures <br />U"' Dimensions, locations and setbacks of all existing and proposed structures including all <br />decks/porches/walkways/etc; must show dimensions for ALL items <br />9' Existing and proposed utilities and utility easements <br />Sanitary system, drainfield and well with distances to property lines, OHWM, wetlands, floodplains, existing and <br />proposed buildings <br />❑ Location and extent of filling/grading <br />❑ Location and type of erosion control measures <br />❑e' Any other construction related to your project <br />&' North arrow <br />Page 2 of 4 <br />Burnett County, W1 Conditional Use Permit (CUP) Application — Rev 3/2017 <br />