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ADDITIONAL PROVISIONS <br />• Removal or cutting of trees and vegetation, as well as filling and grading are restricted within the shoreline area. Restricted <br />Thor: ine area is all area from the OHX'i M to 50 ft from the OHWM landward. Contact die Land Services Department prior to <br />cutting any shoreline trees and vegetation. <br />No structures arc allowed within any setback, wiless specifically permitted. <br />• Driveway must meet width/height requirements within 60 days of permit issuance date. <br />• Accessory structurclgarage permits allow for private residential storage only. Not to be rented or used for human habitation. <br />• TOWN/UDC PERMITS MAY BE REQUIRED FROM TOWN MUNICIPALITIES. PROPERTY OWNER IS <br />RESPONSIBLE FOR CONTACTING THEIR TOWN FOR MORE INFORMATION. <br />• THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE. ONE EXTENSION MAY BE GRANTED. <br />• THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br />REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT. <br />You (owner) are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <br />Wetlands that are not associated with open water can be difficult to identify. Failure to comply 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 4hat this applicatiou (including any accompanying drawings and plans) has been examined by me, and to the best of <br />my knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br />Information contained in this application (Including any accompanying dra-wings and plans), and 1 further declare that I recognize <br />that this information prodded will be relied upon by Burnett County in determining whether or not to issue a permit. I accept all <br />tirtbittity that may be a result of Burnett County relying on the information I nm providing in this application. I acknowledge that 1 <br />will abide by all private/pubtic covenants, restrictions, leases and easements which may apply to this parcel. I agree to permit county <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 />Yeil01i'NEWS SIGNATURE: 1tj0jjA r / v- <br />(DATE) <br />Property Owner is required to sign and date this application. <br />SUBMIT COMPLETED APPLICATION, MAPS, PLANS AND FEE TO: <br />BURNETT COUNTY LAND SERVICES <br />1410 COUNTY ROAD K, R 120 <br />SIREN, WI 54872 <br />APPLICATIONS WILL BE ACCEPTED VIA USPS, ANY STANDARD COURIER, OR IN PERSON. PARTIAL OR INCOMPLETE <br />APPLICA'T".ONS WILL BE RETURNED TO THE APPLICANT. NO EMAIL OR FA-X APPLICATIONS ti L.L BE ACCEPTED. <br />ONLY CHECK, MONEY ORDER OR CASH PAYMENT WILL. BE ACCEPTED. CREDIT OR DEBIT CARDS ARE NOT ACCEPTED <br />AT THIS TIME. PLEASE, MAKE CHECK PAYABLE TO: BURNETT COUNTY LAND SERVICES <br />Please call the Land Services Department if you have questions. 715-349-2109 <br />Burnett County, W1 ordinances can be found at: httv://ww,%v.burnettcountv.com/index.asox?NI1=1043 <br />Page 3 of 4 <br />Burnett County, WI Land Use Application — Rev 1/2019 <br />