2010/07/20 - LAND USE - LUP - Other

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ON CUMPUTER/SCANNED C 2 Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a o APPLICATION FOR LAND USE PERMITS y: v Rct�h awld TELEPHONE o S/— aoq-—r7e3vjst0 r/ =oMaryAnr, TU�uS < <sd MAILi,NG3�RE51„/j . P/ `•/07"ORC�rvS / � Y?"GC� — wIs 16(/('<f e W y S7 ZJy� p J LEGAL DE5�7rVCJ7C SU�'V E)( /yGp No �tG o_ TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE BUNKHOUSE ❑ 59.692(IV)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ I(1_ v COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o 7 STRUCTURE/ADDITION USE: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) J BUILDING CONTRACTOR: 5e r) c� A PLOT PLAN MUST BE PROVIDED ON AN 8 W X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS c_ _ WILL BE RETURNED. � n DIRECRONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) M —�V 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m A n 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW m oe 3 BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, l AND INDICATE NORTH (N). N SU o 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 5 (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST) AND DRAINFIELD(DF),AND ALL DISTANCES 4_1 TO BUILDINGS, ROADS, LAKE, LOT LINES. 3 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 c C� PLANS MUST BE SIGNED AND DATED BY THE OWNER. n R) 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: 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. t� Z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. O 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. NOT TO BE USED FOR HUMAN HABITATIONI,� 6. f5�$ -17� �'t"� QCCC.SStJ�y SIrLeC�'LLYY.')'hroL -1'h2lAJL�llf�rd 1sQ.11o E 7. F(11 i +VWe+Iand is n,�t allowed- > r) e > lz � no � = I declare that this application(including any accompanying schedule)has been eumirhed by me and to the best of my 3 g ? � �. �. knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information mntalned In this application(including any accompanying schedule)and I further declare that I recognize that this e.> c m N : Y Information I am providing will be relied upon by the County of Burnett WlsmrWn In determining whether to Issue a permit. I 2 ?w 7 v further acoept all liability that may be a result of the County of Burnett retying on this Information I am providing In thisc o N w`^ 'd application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have ^ c' o o o r access to the above-described premLs ss at any reasonable time for the purpose of Inspection. ° d ajCtAH Aq OWNER'S SIGNATURE �/� (date)u o w o 9 d. =x ZONING ADMINISTRATOR l / 'r h / �`�n("lan 1 P' c > aee w - 5 TOWNSHIP PERMITS MAY BE REQUIRED a "' THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE »= w J N O H U N f mrf le c� l7ed t-oj"be-Th"'s