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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator � <br /> a� <br /> APPLICATION FOR LAND USE PERMITS = - <br /> W <br /> OWNER — TELEPHONE 651-5-65— y <br /> MAILING ADDRESS <br /> LZ <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION oc fi l0 iI A. C. z <br /> L.oLYl INp1 T39RIk1J <br /> TYPE OF PEAMrt(5): SINGLE-FAMILY DWELLING❑ ADDDD ITION DE1y CK❑ GARAGE/ACCESSORY STRUCTURE O <br /> BUNKHOUSEE] 59.692(IV)GAZEBO O STAIRS O FILLING/GRADING O CAMPING UNIT D <br /> COMMERCIAL BUILDING O COMMERCIAL ADDITION O COMMERCIAL ACCESSORY STRUCTURE O -� <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Be <br /> droom; Deck; et<.) <br /> BUILDING CONTRACTOR: (:fes t'pq <br /> n <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS s <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PIAN DRAWING: (ARIAL OR TOP VIEW) <br /> J <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES ALL EXISTING <br /> TO BE SHOWN S/DRAWN RE SCALE. w <br /> cS <br /> 2. SHOW THE LOCATION AND SIZE OF ALL NG DECK BUILDINGS/STRUCTURES(EB)AND ALL NEW S <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, J 9 <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS INO FEET OF THE FOLLOWING: (A)B(S)TO THE R ALL LOT IGHLINES,W TE MARK = 1 w <br /> TO CENTERLINE , ROAD, (0)BUILDING WETLAND A E AREAS, <br /> THE ORDINARY HIGH WATER MARK <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D)LOT DIMENSIONS. 1- <br /> 4. SNOW THE LOCATIONTHE WELL(W),SEPTIC TANK(Si)AND DRAINFIELD(DF),AND ALL DISTANCES - { <br /> TO BUILDINGS, ROADS,, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT ISPUNNED AND SHOW AREAS TO GRADED FILLED. <br /> 6. IF SEPARATE PLANBY ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER, CONTRACTOR, ETC.,THE LLLL,���, <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. ^J) SQL <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: "1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. :' O <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Q <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER n <br /> SETBACK AREA. V <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION, p <br /> 6. seE:A rTAcf/ED �,zsT <br /> 7. —y z 'a e>yF <br /> ' z 3a S . 3 <br /> I declare Mat this ,11callons true, <br /> (includingreefany attolete. I ng scaled e)M1ap been examined of r and to Me best of my .i F 2 <br /> knowledge and belief It N Iroe,coneetn(i complete.an 1 acknowledge Mat ch 1 em rand Ifurthfor Me detail and accuracy of all , p r" E -� <br /> Information morainal In Mis appllcabon(intludinpanyarrnmpanylnq uM1edule)and1furtM1tt declare Matt retopnlie Mat[M1k `2 nc <br /> Information 1 em providing will be relied upon by the County or Bonita Wisconsin In detearmining wNeMer to Issue a permR. I A __•n T <br /> further accept all Nobody that may be a result of Me County of Burnett relying an this Information 1 am providing In MIs <br /> application. I agree to pamitt county officials Naryed wIM adminlNatmg county ordinance¢ r omw authorized moson to have 'J AA , <br /> attest m the above-dexnbed"affil as reasonable time for Me purpase pf Inspection� ' L 8 S ("l <br /> OWNER'S SIGNATURE_ <br /> (date) <br /> ZONING ADMINISTRATOR <br /> CLE2 WE <br /> pc Ear <br /> TOWNSHIP PERMITS MAY BE REQUIRED f: <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF I NW 3 0 2014 o <br /> BURNETT COUNTY <br /> ZONING <br />