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ADDITIONAL 1'R(?V14,11(?NS
<br />• Removal or eulting otters and ,egct:ui. tilling and grading are restrictvsl wtthrn th,° tihcrry
<br />shorelinelrnt arca Rc,(ricta!
<br />arca is all arcs Irony 111, ( Hl\\ \1 a ';u 11 troru the OIfWM landward (onrtct the I,arrd ervirin Dcrartmcru rrt"r t ,
<br />. titling any ihoreluji, trees Mid�eL!�`l;1t l�Hk
<br />• .Iructurv% are alt,Rticed within am .aback, unle- spectlicall) perntiue,t
<br />• >nvcuay must meet width b"Ieht rcyuucn¢`ntti %rutin (III days of permit t„u,ur,r .late
<br />• N:Lcs+nry struchne c;uai 1*, rr,;n. ,,i4 ,. I,,t hrtvaly rQ,0eotial st,ita,vv only Not to be rented or used for human habitation.
<br />•
<br />10\4"N I t)( PI t011I" \1 \1 lit RFOl IRF'D FROM IO\N\ %it \l('IPALII IF.S. PROPER IY O\\-,Vk IS
<br />RESTO\\lIt[ l l tt►t II\ 1 \( I I\(, 111E:IR 10%%N FOR vlORF I\FOR`I AIIO\,
<br />• I'fill, Ilk k%I1I \IItl I 1\1'IkF O\t 11 III RFRMI 1)AIEOFISSI \\( I_O\k.F'.\'it:\SIU♦ \1 \t Ilk (:R:\\Ik.D.
<br />•
<br />111 IN \I't'1 k\ 1 It )\ t O\s 1 I I t I F S \OTI( F. 1 N A I ALL INIPRO\ [AWN I S AR!, SI B.IF ( I I O V( k SS ANI) UR
<br />RF\ II \\ 111 111 k. I U \11 \1( 1'\I.11N'S IAX ASSESSOR FOR IIlk PI RP( St OF 1 \\ \SSI SS\tE\1.
<br />1 �'u Icavcnel ,ae ,r„nohle liar cotttpl)uty ,kith state and tcderal law, conceming arnstruction near or on wetlands. Takes, and strearrr,_
<br />1\etlands that are not associated with „pen crater can he difficult to identify. failure to comply may result in removal or modification of
<br />construction that vrolatcs the !aw or other rcnaltirs nr costs. For more information visit the Department of Natural Resorres wetland
<br />;Jcnufication wch pare or contact a Derartment c4 Natural Resources service center
<br />1 (owner) declare that this application (including any accompanying drawings and plans) has been examined h% me, and to the best of
<br />my knowledge and belief It is true. correct and complete. 1 acknowledge that 1 am responsible for the detail and accuracy of all
<br />information contained in this application (including any accompanying drawings and plans), and 1 further declare that I recognize
<br />that this information provided will be relied upon by Burnett Counh in determining whether or not to issue a permit. 1 accept all
<br />liability that may be a result of Burnett County relying on the information 1 am providing in this application, 1 acknowledge that I
<br />will abide by all private•'puhlic covenants, restrictions, leases and easements which may apple to this parcel. I agree to permit count.
<br />officials charged with administrating county ordinances or other authorized persons to have access to the above-described premises
<br />at any reasonable time for the purpose of inspection.
<br />--- %DDIIlONAI. COMMf:N 11, FROM O\V'\l R AH (Ak"I D III Rl ---
<br />OWNER'S SIGNATURE: _ /J�� _ __— -- �✓� � I � 0
<br />(DATE)
<br />Prorx:rt. Owncr i, rcgtjircd to sign and date this application
<br />SUBMIT COMPLETED APPLICATION. MAPS. PLANS AND FEE TO:
<br />BURNETT COUrNTY LAND SERVICES
<br />7410 COUNTY ROAD K, 111 120
<br />SIREN, WI 54872
<br />APPLICATIONS WILL 131: ACCT PIED VIA USPS, ANY STANDARD COURIER. OR IN PERSON. PARTIAL OR INCOMPLETE
<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 ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED
<br />AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNPAT COUNTY LAND SERVICES
<br />Please call the I -and Serviurs Department if you have questions. 715-349-2109
<br />Burnett County, WI ordinances can be found at: http:!✓wwlv.burnrttcuunty.com;index.aspx?N'II r-104.3
<br />Page 3 of 4
<br />Burnett County, WI Land Use Application — Ref 312018
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