2015/03/30 - LAND USE - LUP - Other - LUP-15-21

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r Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator d a C APPLICATION FOR LAND USE PERMITS OWNER TELEPHONE _7Ia- aat-3�-.�`) PROPERTY ADDRESS ..7 lP r) ? `_ � L u�A 1&Li 5-' VJ �y on4s'bt1Y5 W i 5440 1 , LEGAL DESCRIPTION 3 5 - ?-)Ci N nxxX`»J` MAILING ADDRESS I111p LJ4 'WSi Ra C,r)t Kop.Scar I D 50N) TYPE OF PERMIT(S): ❑ Single Family Dwelling Garage/Accessory Structure ❑ Stairs ❑ Commercial Building ❑ Addition ❑ Bunkhouse ❑ Filling/Grading ❑ Commercial Addition ❑ Deck ❑ 59.692(ly)Gazebo ❑ Camping Unit ❑ Commercial Acc. Structure STRUCTURE/ADDITION USE: S-TOr C,54 She t� z n(Home/Cabin;Commercial Business; Bedroom; Deck; etc.) o BUILDING CONTRACTOR: S9 n PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. ***REQUIRED PLOT PLAN INFORMATION*** - O n 81/20 X 110 SHEET OF PAPER DISTANCE(IN FEET?TO: o ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD Dimensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED w L7 EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc.) 4CENTERLINE IF NOT SURVEYED -Dimensions& Heights ❑ ALL PROPERTY LINES W NORTH ARROW ❑ ORDINARY HIGH WATER MARK i S. ❑ ALL WETLAND AREAS " rn NOTE: Building/structure location must be staked for onsite verification when needed. o THISPERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ECS VISE � • Removal or cutting of trees and vegetation is restricted along shoreline .1 • p No structures(including retaining walls,etc.)are allowed unless specifically perm FEB li 0 ��•� U' • No filling,grading,or shore land alterations are allowed unless specifically permitted + • Driveway must meet width requirements within 60 days of permit • Accessory structure/garage permits allow for private residential storage onlyBU�4l a LTT s ,,s•.: C3 "Not to be used for human habitation or rental storage** Tf. ;,tt_ z 1 declare that this application(including any accompanying schedule)has been examined by me and to the beat of my knowledge and belief it is truq correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize that this information provided will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit 1 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 county officials charged with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. --ADDITIONAL CONDITIONS--- p A 0 D 0 oon 0 D Q n � -Y5'�G� 3goma n E l��nr � S�I �^4 Y�U't'fnv-� Ur Ur PYhP✓� � yr°y y 3 � 9 " a rn CSP �l — 3 : / r n 07 yw P' ir: Bui�drit� -IP 7 �o exce� 3S LI e f9 l r f / 1 a �, N rD 'n w-: Nn O � � $ O O rw• OWNERS SIGNATURE m ZONING OFFICIAL z6�I Zo 5 o a C7 d __ O' F -. 5, ( I rn : a � y "'•TOWN/UDC PER ITS MAY ** BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE o p a o^ You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification in w of construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources $ wetlands identification web page or contact a Department of Natural Resources service center. d '^ `_ 1 i