2004/11/15 - LAND USE - LUP - Other

Home Browse Search

Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -D ci Z APPLICATION FOR LAND USE PERMITS 3° C OWNER 6 A n i_g�!j L i:�4tW,jI TELEPHONE -1 M � 1S 47 ZOt-9 o MAILING ADDRESS ri 57 Mo1Srr Lot � r m PROPERTY ADDRESS �JQ S? r,�fC gZj�� —5pomle--1 Lk, I �yg� 6 2� PJ-a,cr rC Lv'rs 13, r , is �— t� LEGAL DESCRIPTION(see tax receipt) 13 ZK I ML—ft-EN L t L L14. 6 C,13 Z71 15 t CIV a W r Ora � I4w m DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE 11 ADDITION p TYPE OF PERMIT(S): C 0 FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ _a STRUCTURE/ADDITION USE: 17 ll yo (Home/Cabin, Commercial Business; Bedroom; Deck; etc.) Cn –� BUILDING CONTRACTOR: ? U u A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR _ ILLEGIBLE PLOT PLANS WILL BE RETURNED. v -n 3 Set C"I"N 5"rt O DIRECTIONS FOR PLOT PLAN DRAWING- (AERIAL OR TOP VIEW) �)nc- S�tfG�f O (� ✓/ CD n a 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T ? 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m o C)) NORTH(N). m m 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m ( 3 CENTERLINE OF ROAD,(C) BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF �-° LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. Z 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILDINGS,ROADS, LAKE, LOT LINES. –� 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. t 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS C> ° MUST BE SIGNED AND DATED BY THE OWNER. o f t NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o NEEDED. THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z CONDITIONS OF PERMIT: o T �I ) b O 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT C� ISSUANCE. A . 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. In 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY ((�� PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA, 5. A aoOr > > 6. m c m m 0 m a F m N J'C 3 �. 2 0JLd r�t1 7. ° o m cN^ o 3 I declare that this application (includio Tom . . m ng any accompanying schedule) has been examined by me and to the best of my vis p knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m C : c all information contained in this application (including any accompanying schedule)and I further declare that I recognize 0 0 rpn that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to recognize is- m M sue a permit. I further ac ept 11 liability which may be a result of the County of Burnett relying on this information I am d o providing in this applic n. agree to permit county officials charged with administering county ordinances other cD authorized person to h ac ss to t e which a described premises at any reaso I ion. -n a : SIGN HERE > : (si a re of owner u' in contractor) (date) r p q p, ZONING ADMINISTRATOR NOV ? 2004 NDntE '7-3 -b3 a 7 69 uv N TOWNSHIP PERMITS MAY BE REQUIREIPURNE17 COUNTYd g N o W N g THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSNNhU IVEL' /i-,a Z-qc/ 46 Biad(R y�/�,elch;c Lehr�e /l-/s -OS!