2006/04/20 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator z APPLICATION FOR LAND USE PERMITS a m y O � s C m OWNER Kevin Wayne Bluhm TELEPHONE 715-425-5113 he rn.Qi MAILING ADDRESS 1109 Pine Ridge Dr. R1 0610 SyOZ Z 0 < n PROPERTY ADDRESS Lot 3 Dushane Drive, byj sive 3 D o } Gogh Lols -S--e6, Seo. / -7, 1WAV YO W. R;fv6Ey a / / 6, (:7 3, LEGAL DESCRIPTION Lor 3 / 7 CSM 56 :2 , S'/,q�, 7oc i., of S-00 77 TYPE OF PERMIT(S): DWELLING/BUILDING El STRUCTURE ADDITION STAIRS FILLING/GRADING ❑ CAMPING UNIT❑ BUNKHOUSE❑ 59.692(1V)GAZEBO ❑ DECK❑ n 3 STRUCTURE/ADDI110N USE: Cabin Garage TH/S �E�/Y/iT Z 0 (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) o 4 BUILDING CONTRACTOR:_Self I p A PLOT PLAN MUST BE PROVIDED ON AN 8 1/3 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. ons y ^ DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) bn s 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. � 00p ' d lral 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW C BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, o AND INDICATE NORTH(N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S) n TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK O c (OHWM)OF LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 'z I 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES r, 'F+ c) o TO BUILDINGS, ROADS, LAKE, LOT LINES. 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. z o 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE Y PLANS MUST BE SIGNED AND DATED BY THE OWNER. c i NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE DONE WHEN O NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: a '� O• 1. .DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. R R) 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. x P 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. r 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER xV_ SETBACK AREA. S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. 6. anmoaoe 7. I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge a �,C R y and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information " o contained in this application(including any accompanying schedule)and I further declare that I recognize that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I further accept all n N c N N o b liability that may be a result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have access to the above-described premises at any reasonable time for the purpose of inspection. i to SIGN HERE ��;{ f7-��ri+i- � � 1Jp n2 - (signature of owner ofuilding contractor) (date) ,`� `O o D a p 7 2006 ZONING ADMINISTRATOR IL(,n ( APR P o1j Li U ' N, TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUAAUNG vp S N o m �� + le l lam' tic �tpby �CP,�iv� t�l�hfn, L4 13. o'�