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ADDITIONAL PROVISIONS <br />the OHWM landward. Contact the Land Services Department prior to <br />Rem <br />oval or cutting of trees and vegetation, as 0 ft r well omilling and grading are restricted within the shoreline area. Restricted <br />shoreline area is all area from the OHWM to 5 <br />cutting any shoreline trees and vegetation. <br />erntitted. <br />No structures are allowed within any setback, unless specifically p <br />• Driveway must meet width/height requirements within 60 days of permit issuance date. <br />Accessory structure/garage permits allow for private residential storage only. Not to be rented or used for human habitation. <br />A 17' <br />IS <br />• TOWN/UDC PERMITS MAY BE REQUIREDFROM TOWN MUNICIPALITIES. TOWN FOR MORE INFORMATION. ROPERTY OWNER GRANTED. <br />RESPONSIBLE FOR CONTACTING THEIR <br />THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE O ROVEMENTS ARE SUBJECT TO ACCEAND/OR <br />THIS APPLICATION CONSTITUTES NOTICE THAT <br />REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT.and streams. <br />lands, lakes, <br />You (owner) are responsible for with open Water can be diffiith state and cult toeral identify. dent fy. ws concerning <br />Failure to comply may result n rtemoval or modification of <br />Wetlands that are not associated with ope <br />construction that violates the law or other penalties or costs. R�ces servicemore ocenteon visit the Department of Natural Resources wetlands <br />identification web page or contact a Department of Naturalesou <br />ans) has been <br />ined by <br />d to the best of <br />I (owner) declare that this application (including any accomcomplete. <br />anying I acknowledgegs and that I am responsible for the detailnandnaccuracy of all <br />my knowledge and belief it is true, correct and complete. <br />I recognize <br />information contained in this application (including <br />g any <br />yarn Countypanyingn determining whether odrawings and plans), r notutohssueealperm t t I accept all <br />that this information provided will be relied p Y providing in <br />e that I <br />liability that may be a result of Burnett County relying <br />ons eases and easelments whon I nch may apply t hthispparcel1OI agree to permit county <br />will abide a all with administrating <br />covenants, restrictions, <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 />---ADDITIONAL COMMENTS FROM OWNER ALLOWED HERE--- <br />3 G gal <br />OWNER'S SIGNATURE: (DATE) <br />Property Owner is required to sign and date this ppl. ation. <br />SUBMIT COMPLETED APPLICATION, MAPS, PLANS AND FEE TO: <br />BURNETT COUNTY LAND SERVICES <br />7410 COUNTY ROAD K, #120 <br />SIREN, WI 54872 <br />N. <br />APPLICATIONS WILL BE ACCEPTED VIA US, ANY STANDARD COURIER, OR IN <br />D TO THE APPLICANT. NO EMAIL OR FAX APPLICATIONS WILIL BE ACCETE <br />EP ED <br />APPLICATIONS WILL BE R <br />ONLY CHECK, MONEY ORDER HECK PAPAYMENT YABLE TO: OWILL <br />BE AT COUNTY LANDI SERVICES EBIT CARDS ARE NOT ACCEPTED <br />AT THIS TIME. PLEASE, MAKE <br />Please call the Land Services Department if you have questions. 715-349-2109 <br />Burnett County, WI ordinances can be found at: http //www )urnettcounty.com/index. aspx?NID=1043 <br />Page 3 of 4 <br />