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I(applicant)hereby make application to the Land Use and Information Committee for a Conditional Use Permit(CUP) <br /> for the following: C,i(ai(ytpLep,jj( Dk e, A. 3 i e - ��,P 0,.... /075 <br /> hi/ X oo/ c c i r - Lq p n_o I - C; rnap c 1 ne <br /> :t t,-,C. G 5e.",14:\sn_% 115 'S'o{'e.s cc,vs , :-P Ma '-'t'G- 5 Le.,.1 c„n -K u,.)e s- - <br /> �i,,A. a � 4 v, (.,.nr t-e,l - cur -t cNASA":1 v.c•( 5 S ids r c 4 c^t.c.N-r A,.:k(. <br /> -�&s o.�plrc �, � --6c A owl o-0.11d-P.Ic s t Pc•el 0.,k�0s ja;A:vt'ti.Q,S '1O 9,. t-r <br /> SL s° a 5c .c.,- . F. <br /> A plot plan drawing is required. Plot plan shall be drawn with a scale preferably at 1"=20' or multiples of <br /> 10',scale shall not exceed 1"=50',unless approval from Zoning Administrator for a different scale is <br /> allowed. Note the scale used on the drawing. Plot plan drawing shall be on letter or legal size paper with <br /> North being at the top of the page. (Make sure all items below are shown): <br /> ❑ Property lines,road right-of-ways,and road centerlines including distances to properly lines,road right-of-1Nays and <br /> road centerlines for all existing and proposed structures on the parcel <br /> ❑ Show area to used for the proposed Conditional Use <br /> ❑ All existing uses on parcels adjacent to the parcel for this request <br /> ❑ All existing zoning districts on parcels adjacent to the parcel for this request <br /> ❑ Vegetation proposed to be removed or disturbed <br /> ❑ Ordinary High Water Mark(OHWM)and distances to it from all existing and proposed structures;must show all <br /> within 200 ft of structures <br /> ❑ Floodplain and wetland boundaries and distances to them from all existing and proposed structures;must show all <br /> within 200 ft of structures <br /> ❑ Dimensions,locations and setbacks of all existing and proposed structures including all <br /> decks/porches/walkways/etc;must show dimensions for ALL items <br /> ❑ Existing and proposed utilities and utility easements <br /> ❑ Sanitary system,drainfield and well with distances to property lines,OHWM,wetlands,floodplains,existing and <br /> proposed buildings <br /> ❑ Location and extent of filling/grading <br /> ❑ Location and type of erosion control measures <br /> ❑ Any other construction related to your project <br /> ❑ North arrow <br /> Page 2 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP)Application —Rev 11/2019 <br />