2011/10/13 - LAND USE - LUP - Other

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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g ° APPLICATION FOR LAND USE PERMITS N 5-a34-15-s/ (CA)) a OWNER ro+t;47`/�,SQtiIELEPHONE 71s-.;L34- F&89 (rf) = o c MAILING ADDRESS /DOO �' �� S+ '��CQ.. �� ( /`�� PROPERTY ADDRESS 3103 ® K 1A "S. ( e� ,, cz), S / . I T�St�-NGS. 5 LEGAL DESCRIPTION 3/ Q3 Q�lJ��.� l�Y6 •r 1. ,�Uv -0+ TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE 41 w BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ f ro COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ r' 0 STRUCTURE/ADDITION USE: A1cL A... U h L 3 -YC Y �. 0 (Home/Cabin; Commercial Business; Bedroom; Deck; tc.) (yk-}�,(- a BU/IL)DING CONTRACTOR -Q NtrHC� - 0"KyUJzu - a IT7ti)G I" aiQf n •� 1 65S\fSc..E J 1v`•-- "�v'�\� aw`<"� SLK« cAR A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCO PLETE OR ILLEGIBLE PLOT PLANS C o WILL BE RETURNED. +i DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) o 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, p, c AND INDICATE NORTH (N). Jz 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) ° TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S) TO THE ORDINARY HIGH WATER MARK QaQ� �' O (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. IYJ p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES Op TO BUILDINGS, ROADS, LAKE, LOT LINES. �' 1 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. -: 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS MUST BE SIGNED AND DATED BY THE OWNER. _ NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ...i NEEDED, THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: pi l �-. f� v C� O 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. j .z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. d �� 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. G 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. O NOT TO BE USED FOR HUMAN HABITATION. 6. G 7. aa07 I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my o = q a 0 5 knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all d m d w w y Information contained In this application(including any accompanying schedule)and I further declare that I recognize that this Information I am providing will be relled upon by the County of Burnett Wisconsin in deterrnlning whether to Issue a permit. I .� �, a�S b further accept all 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 my offlcI Is charged with administrating county ordinances or other authorized person to have access to the above-descdb p Ises at any re na le time for the purpose of inspection. w N w () A � yg� ogoy OWNER'S SIGNA 3 / nA n ao � (datey , ZONING ADMINISTRATORl/ Ir 1 1 1' 1(t 1(�Ja n y U)7 °c w o Chi M �Ij6 . = t�7 TOWNSHIP PERMITS MAY BE REQUIRED a °° THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N u, �e�m�f- � I e-�� rr�'.i=led F-a So Gin Ne•lsoh �0�-r � � � s o 0 o s