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04/26/2018 01:17 FAX 7158668194 WEBSTER ACE HARDWARE U001 <br />ADDITIONAL PROVISION 5 <br />• Removal or cutting of trees and vegetation, as well as filling and grading are restricted r/ithin the shoreline area. Restricted <br />shorehike area is all area from the OHWM to 50 ft from the OHWM landward. Contac the Land Services Department prior to <br />cutting .any shoreline trees and vegetation. <br />• No structures are allowed within any setback, unless specifically permitted. <br />Driveway must meet width/height requirements within 60 days of permit issuance date <br />• Accessary structure/garage permits allow for private residential storage only, Not to b e rented or used for human habitation. <br />+ TOWN/UDC PERMITS MAY BE REQUIRED FROM TOWN MUNICIPALITII S. PROPERTY OWNER IS <br />RESPONSIBLE ICOR CONTACTING THEIR TOWN FOR MORE 1NFORMA"I' (ON. <br />+ THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE, 01% E EXTENSION MAY BE GRANTED, <br />THIS AXPLICATION CONSTITUTE NOTICE THAT ALL IMPRO'VEMENV ARE SUBJECT TO ACCESS AND/OR <br />REVIEW HY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PUP POSE OF TAX ASSESSMENT. <br />You (owner) are: responsible for complying with state and federal laws concerning constructic n near or on wetlands, lakes, and streams. <br />Wetlands that are not associated with open water can be difficult to identify. Failure to comp( / may result in removal or modification of <br />construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources wetlands <br />identification web page or contact a. Department of Natural Resources service center, <br />I (owner) declare that this application (including Any accompanying drawings and plans) h, :s been examined by me, and to the best of <br />my knowledge and belief it is trite, correct and complete. I acknowledge that I am resp )risible for the detail and accuracy of all <br />information contained in this application {including any accompanying drawings and plat s), and I further declare that I recognize <br />that this information provided will be relied upon by Burnett County in determining whe :her or not to issue a permit. I accept all <br />liability that may be a result of Burnett County relying on the information I am providing in this application. I acknowledge that I <br />will abide by all private/public covenants, restrictions, leases and Casements which may Api ly to this parcel. I agree to permit county <br />officials charged with administrating county ordinances or other authorized persons to ha re access to the above-described premises <br />at any reasonable time for the purpose of inspection. <br />---ADDITIONAL COMMENTS FROM OWNER ALLOWED N ERE--- <br />%5"bc` <br />OWNER'S SIGNATURE - <br />(DATE) t,�'� �� /1 �1 <br />(DATE) <br />Property Owncr is required to sign and date this application, <br />SUBMIT COMPLETED APPLICATION, MAPS, PIANS AND FEE TO; <br />BURNiT COUNTY LAND SERVICES <br />7410 COUNTY ROAD K, # 120 <br />SIREN, 'Wl 54872 <br />APPLICATIONS WILL BE ACCEP'T'ED VIA USPS, ANY STANDARD COURIER, OR IN PI RSON. PARTIAL OR INCOMPLETE <br />APPLICATIONS WILL B1E. RETURNED TO THE APPLICANT. NO EMAIL OR FAX A,PP4) 'ATIONS WILL BE ACCEPTED. <br />ONLY CHECK, MONEY ORDER OR CASH PAYMENT WILL BE ACCPCTED. CREDIT C R. DEBIT CARDS ARE NOT ACCEPTED <br />AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: $! )fit VETT COUNTY LAND SE: IVICES <br />Please call the Land Services Department if you have questions. 71$-349-2109 <br />Burnett Country, WC ordinances can be found at: httg://www.burnettcountv.com/in jex.asnx?N D=1443 <br />Page 3 of 4 <br />Burnett County, WI Land Use Application. — Rev 3/2018 <br />Alf, S#A V <br />