Laserfiche WebLink
i <br /> , <br /> E <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administra or z <br /> APPLICATION FOR ND USE PERMITS a <br /> OWNER ` C TELEPHONE�63-�a6— x°12 e o <br /> Tf J n^ <br /> MAILING ADDRESS —7Z.-� S� N 11A I �1 V <br /> 0 llJf) <br /> SS'{ ( ; <br /> PROPERTY ADDRESS 'z,qL)` Nord-1, �iruT L27j <br /> 1 <br /> n <br /> LEGAL DESCRIPTION <br /> SINGLE FAMILY DWELLING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ STAIR ❑ o a <br /> TYPE OF PERMIT(S): <br /> 9 <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ BUNKHOUSE_❑ 59.692(1V)GAZEBO EI DECK � l/ <br /> STRUCTURE/ADDITION USE: W <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) .°r. <br /> �rn <br /> BUILDING CONTRACTOR: S P, ^ 1 <br /> v1 <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PL NNS O <br /> WILL BE RETURNED. <br /> O ° <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. I 0 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING B ILDINGS/STRUCTURES (EB)AND ALL NEW C <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, oa <br /> AND INDICATE NORTH (N). �� o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDIN (S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK I l <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. ^. <br /> 4. SHOW THE LOCATION OF THE WELL(W) SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTAN CES ? 9 <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,I HE _ <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WF EN <br /> NEEDED. 4 (� <br /> ' . <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELO : <br /> r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIRE ENTS WITHIN 60 DAYS OF PERMIT. z 10 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION S RESTRICTED ALONG SHORELINE. n vV <br /> 3. NO GRADING OR SHORELA.ND ALTERATIONS.ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER S <br /> SETBACK AREA. O <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE O LY. Q <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. DomO Dod <br /> R3 a � C+7 <br /> 7. <br /> I declare that this application(including any accompanying schedule)I as been examined by me and to the best of my knowle ge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information c o 2 <br /> contained In this application(including any accompanying schedule)ard I further declare that I recognize that this Information I Z�Ew N 'atl <br /> am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a pennit. I further accep all <br /> liability that may be a result of the County of Burnett relying on this in ormation I am providing in this application. I agree to <br /> permit county officials charged with admin rating co ty ordinances r other authorized person to have access to the above- 3 S (] <br /> described premises at any reason a ti r the p of Inspecti . <br /> OWNER'S SIGNATURE J LVO m .5 <br /> °n a '+1 <br /> ZONING ADMINISTRATOR __ <br /> TOWNSHIP PERMITS MAY BE REQUIRED v <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE v o w <br />