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2019/06/12 - LAND USE - LUP - Dwelling/Principle Building - Single Family - LUP-19-190
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2019/06/12 - LAND USE - LUP - Dwelling/Principle Building - Single Family - LUP-19-190
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Last modified
3/5/2020 10:06:44 PM
Creation date
6/12/2019 9:53:02 AM
Metadata
Fields
Template:
Property Files v2
Document Date
6/12/2019
Document Type 1
LAND USE
Document Type 2
LUP
Document Type 3
Dwelling/Principle Building - Single Family
County Permit Number
LUP-19-190
Tax ID
5986
Pin Number
07-012-2-40-15-34-4 04-000-011000
Legacy Pin
012423404610
Municipality
TOWN OF JACKSON
Owner Name
BRUCE A & TONIA J NELSON
Property Address
4239 MALLARD LAKE RD
City
WEBSTER
State
WI
Zip
54893
Previous Owners
BRUCE A & TONIA J NELSON
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I <br />ADDITIONAL PROVISIONS <br />• Removal or cutting of trees and vegetation, as well as filling and grading are restricted within the shoreline area. Restricted <br />shoreline area is all area from the OHWM to 50 ft from the OHWM landward. Contact the Land Services Department prior to <br />cutting any shoreline trees and vegetation. <br />• No structures are allowed within any setback, unless specifically permitted. <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 />• 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 that this application (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 drawings and plans), and I further declare that I recognize <br />that this information provided will 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. 1 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 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 />--- ADDITIO AL COMMENTS FROM OWNER ALLOWED HEPE--- j T <br />tt'r ltc a S 3UU°lz c �L 1,� C <br />d t t L4SE�'- c' t ,. C 4/ <br />S�i� Oc��� T3VitiJ`"J T <br />ZO � S` <br />I -so �i c,1� S t � 3 (R� - �. � J1 <br />� i�cl� cti �7 c' �-t` �'` c b _ ' <br />OWNER'S SIGNATURE: 1 Z l Z 1 �— <br />(DATE) <br />Property Owner is required to sign and date this application. <br />SUBMIT COMPLETED APPLICATION, MAPS, PLANTS AND FEE TO: <br />BURNETT COUNTY LAND SERVICES <br />7410 COUNTY ROAD K, #120 <br />SIREN, WI 54872 <br />APPLICATIONS WILL BE ACCEPTED 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: BURNETT COUNTY LAND SERVICES <br />Please call the Land Services Department if you have questions. 715-349-2109 <br />Burnett County, WI ordinances can be found at: http://ww,Nv.burnetteounty.com/index.ast)x?NID=1043 <br />Page 3 of 4 <br />Burnett County, WI Land Use Application — Rev 8/2018 <br />
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