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IN SCENE; W
<br />A111D U MNAl,. plI ()VISIONS
<br />w I emir al �}r tittin t�f tree; ttnil ti ,t�,c'taiifiii. a., I,sclf iv, fill mf; artcl gr idinu are restricted tivithin the shoreline area, Restricted
<br />It xrcliIl < tea is all arc,i Iron thin OI I\V�1'O +17 11 16a) n Icr C)I IAAI,*vl landward. t oniact the I -and Services [department prior to
<br />cantina, any shoreline trees and
<br />No structures are_' allowv l within any s�tl;acl., auil, , zpu�,ifically permitted.
<br />Ie)rivev `ay must nieCt v;ichh'hei,�,ht regtthcnwiw, cyithin 0 flays of pQrntit issoance clime.
<br />* Ace:essory'atrttctni k�,ar,i c permitr; allmi Iur pl i%akc residential storage only, Not to be rented or used for human habitation.
<br />I'OWN/1 W PF'.ItlII lS NIA1' IIF': 121;()C1ItF;U I,'ROm VOA'1'N N1 t`NIC'1112A11_,ITIES. PROPERTY OWNER IS
<br />RLSPCINSIBIA" FOR CON I AC1'IN(. "1"IILIR TOAA`X 1,011 NIORF, INFORMATION.
<br />TIIIS PF'RNIf1SMALL EXPIRE ONL N LAR VRC1M DATE OF ISSt AN(F. ON*L F:X`I'ENSION 7A1AY BE GRANTED.
<br />I'llis A1111LIC'AII0N CONST 1'I I 'IT"', N,011(1: 'I ILVII, iAL1. I%IPR0 \ ENIF:.iS ARE SUBJECTTO ACCESS AND/OR
<br />I2EXIIIAN" 131' 1 H LO( AL \11 NI( rkil f I I "sTAX:ASSESS(,m tolt blit. 1'VItPOSE OI' TAX ASSESSMENT.
<br />4'cm (c)%yner) arc responsible for complying kith state and Icdcral laws concerning construction near or on wetlands, lakes, and streams.
<br />VA etlatnds that are nut associatcd with oprn tiVciter Cali he difficult to identify. Failure to Comply may rssult in removal or modification of
<br />cunStructiOn that the Iiiw en- c)thcr panalties or cast:,- For niore infbrmati(m visit the Department ofNahtral Resources wetlands
<br />1C!Cnt[ficatton 'xeb payv oi- covttii t it of X'itnirid RQ,,ourCCs scrvicc (:ewcr.
<br />I (owner) declare that this application (inchnfint" any accompanying drawings and plans) has been examined by me, and to the best of
<br />nay knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy ofall
<br />information contained in this application (inehiding arc accompanying drawings and plans). and I further declare that I recognize
<br />that this information provided Ni ill be relied upon by Burnett County in determining whether 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 1
<br />will :abide by all private/public covenants. restrictions, leases and easements which may apply to this parcel. I agree to permit county
<br />officials charoed %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 />---.ADDI I IONAL C:ONISIIIN FS PItOV1 MNI::ALL(M 111) f
<br />(1-11 014 NE SSIGNrATURE; � �. � l-=,1 C(�),t
<br />(DATF)
<br />llrop,:rty O,,kner i.> required it) situ aml d•tc this application
<br />Stt13?vlIT CONIPLE 114) .APPLICATION. MAPS, PL:A\S .A\€) FFF 10:
<br />BURNIE'iT C'OI :` FY L.,kND SERV"fCk'S
<br />7,11(1 COIJINTY Rt) 11") K4 '"120
<br />SIREN, NN1 54372
<br />,API'LIC'.:
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