2006/04/20 - LAND USE - LUP - Other (3)

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Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator APPLICATION FOR LAND USE PERMITS y H N 7 0. OWNER Kevin Wayne Bluhm TELEPHONE 715-425-5113 �� / l 65/- zso- s7y7 - work MAILING ADDRESS 1109 Pine Ridge Dr. TR/veg 5FALLVvS, / 541oa I PROPERTY ADDRESS Lot 3 Dushane Drive, DlQ,n/8U(•(Y Go✓j Lc��s S.rtS, Sec. / 7, tf0 N. /? 6f /VW, 6 C LEGAL DESCRIPTION �. Lor 3 /7 GSM 56 . `>'� Tc✓n of Sco7r DWELLING/BUILDING❑ GARAGE/ACCESSORY STRUCTUR ADDITION ❑ STAIRS Cl TYPE OF PERMIT(S): IN FILLING/GRADING❑ CAMPING UNIT 0 BUNKHOUSE 0 59.692(1V)GAZEBO❑ DECK❑ Pgf7- STRUCTURE/ADDITION USE:_Cabin( aeblaal meckc z° BUILDING CONTRACTOR:_Self S b A PLOT PLAN MUST BE PROVIDED ON AN B Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) f] �• o. S. o 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW g. .. BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, y AND INDICATE NORTH(N). n 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDINGS) o TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK I� v (OHWM)OF LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. �y c 4 .SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES .� TO BUILDINGS,ROADS,LAKE,LOT LINES. 00 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. r? o O 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE B y PLANS MUST BE SIGNED AND DATED BY THE OWNER. o Q R NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN o. NEEDED. $ 6 THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ^ i S a 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER d, SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATION. p 6. > O oa• E [roil fRC n r 7. N ON = : PQO 3 ..� .. I declare that this application(including any accompanying schedule)has been examined by mea to the best of my knowledge . z v, A and belief it Is true,correct and compiete. I acknowledge that I am responsible for the detail and accuracy of all information contained In this application(including any accompanying schedule)and I further declare that I recognize that this information I o ? g m n m L,t v c 7 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit.tion. I agree Teee toppermi[ o N o liability that may be a result of the County of Burnett relying on this information I am providing in this app' 9 E; U n county officials charged with administrating county ordinances or other autho 'zed person to have access to the above-describedL) d o 21= a premises at any reasonable time for the purpose of inspection. �. = te U F, m z SIGN HERE m � saa (signature of owner of building contractor) (dace) y� : _ii ZONING ADMINISTRATOR V ` TOWNSHIP PERMITS MAY BE REQUIRED N O W N lam/. THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCEn ^ " - � ma. i led +'o KeVi� ► ohm y it -o� v "