2010/11/10 - LAND USE - LUP - Other

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z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a � APPLICATION FOR LAND USE PERMITS N OWNER TELEPHONE GS1„q34-ff3` elRQD L)Lgti-L O � MAILING ADDRESSAl SA[L-,ee, PROPERTY ADDRESS 0S p �I /71 2� G (i "/ c °< d LEGAL DESCRIPTION C- o -4— TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK❑ GARAGE/ACCESSORY STRUCTURE ❑ -0t BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ I(�Q z O COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ S' STRUCTURE/ADDITION USE: Oee'k '&rAK�) I.)- % c (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) BUILDING CONTRACTOR: ¢,. '1154w-rL n � p 3 � A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o WILL BE RETURNED. n DIRECRONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) M 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW 'O `X 9 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, C) v AND INDICATE NORTH (N). O�ll z 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w5' Q (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. O 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF), AND ALL DISTANCES 5 TO BUILDINGS, ROADS, LAKE, LOT LINES. 5 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. %zy 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS MUST BE SIGNED AND DATED BY THE OWNER. _ NOTE: NEEDED G/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ` .j THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r 1^ (J) I fes\ .P O 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z G C 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. S 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. S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN 7. H"�yU�MANH�.�ABITATION. vv T � D000nagro x � L° 33on I declare that this application(including an accompanyingschedule has been examined b me and to the hest of m g o Z 9 S? w' PP ( 9 Y ) Y Y knowledge and belief R Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all a to E;$L Information contained In this application(Including any accompanying schedule)and I further dedare that I recognize that this $ S.a a m Infornatiun I am providing will be relled upon by the County of Burned Wisconsin In determining whether to Issue a permit. I a $° further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this o '� application. I agree to permit county officials charged with adminlstiating county ordinances or other authorized person to haveSpedlon. z 8 g $ access to the above-described premises at any reasonable time for the purpose of In w��'" a OWNER'S SIGNATURE % ' a E:° p1 n rn+t O v c7 (date) do aaseNas ZONING ADMINISTRATOR `'� 'e w' : e 0 m acF: —gm cy TOWNSHIP PERMITS MAY BE REQUIRED THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE QF ISSUANCE v In H O O O O O P�lm � � � 1e �4�✓ m� i`le�i wk'vbul (Stbcrl