2019/04/10 - LAND USE - LUP - Dwelling/Principle Building - Single Family - LUP-19-39

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ADDITIONAL PROVISIONS • Removal or cutting of trees and vegetation, as well as filling and grading are restricted within the shoreline area. Restricted shoreline area is all area from the OHWM to 50 It from the OHWM landward. Contact the Land Services Department prior to cutting any shoreline trees and vegetation. • No structures are allowed within any setback, unless specifically permitted. • Driveway must meet width/height requirements within 60 days of permit issuance date. • Accessory structure/garage permits allow for private residential storage only. Not to be rented or used for human habitation. • TOWNIUDC PERMITS MAYBE REQUIRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS RESPONSIBLE FOR CONTACTING THEIR TOWN FOR MORE INFORMATION. • THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE. ONE EXTENSION MAY BE GRANTED. • THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR REVIEW BY THE LOCAL MUNICPALIT'Y'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. You (owner) are responsible for complying with state and federal laws concerning construction near or on wetlands, takes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources wetlands identification web page or contact a Department of Natural Resources service center. I (owner) declare that this application (including any accompanying drawings and plans) has been examined by me, and to the best of my knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of an information contained in this application (including any accompanying drawings and plans), and I further declare that I recognize that this information provided will he relied upon by Burnett County in determining whether or not to issue a permit. I accept all liability that may be a result of Burnett County relying on the information I am providing in this application. I acknowledge that I will abide by all private/public covenants, restrictions, leases and easements which may apply to this parcel. I agree to permit county officials charged with administrating county ordinances or other authorized persons to have access to the above -described premises at any reasonable time for the purpose of inspection. ---ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE --- OWNER'S SIGNATURE" �--- (DATE) Property Owner is required to sign and date this application, SUBMIT COMPLETED APPLICATION, MAPS, PLANS AND FEE TO: BURNETT COUNTY LAND SERVICES 7410 COUNTY ROAD K, #120 SIREN, WI 54872 APPLICATIONS WILL BE ACCEPTED VIA LISPS, ANY STANDARD COURIER, OR IN PERSON. PARTIAL OR INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT, NO EMAIL OR FAX APPLICATIONS WILL BE ACCEPTED. ONLY CHECK, MONEY ORDER OR CASH PAYMENT WILL BE ACCPETED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SERVICES Please call the Land Services Department ifyou have questions. 715-349-2109 Burnett County, WI ordinances can be found at: hltl)://iitvtv.bnt•neitcountltcorn/index aspx?NID=I043 Page 3 of 4 Burnett County, W1 Land Use Application — Rev 112019