Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a 3 <br /> APPLICATION FOR LAND USE PERMITS W <br /> OWNER b� / I� .1 / 1 <br /> 7'�0_ PA Rwel Ic—g I 4 <br /> IEEx1 TELEPHONE/ <br /> MAILING ADDRESS <br /> PROPERTYADDRESS a T..,da� ( Dt(nds ed y✓ <br /> LEGAL DESCRIPTION Lot / �S � `j <br /> l./ o ..q <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITIO DECK❑ GARAGE/ACCESSORY STRUCTURE ❑ v, <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ I_ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ c <br /> STRUCTURE/ADDITION USE: /� / 3' <br /> (Home/Cabin; Commercial Business; Bedroo eck; etc.) <br /> BUILDING CONTRACTOR: illin <br /> n <br /> �nn E Q G <br /> A PLOT PIAN MUST BE PROVIDED ON AN 8 yz X11 SHEET OF PAPER. ANY I OMPLETE OR LEGIBLE PLOT PLANS o <br /> WILL BE RETURNED. _ <br /> c <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, 3 <br /> AND INDICATE NORTH (N). v <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) 0 0 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK R. <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 DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. _ <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ti <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE --I <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. /BVI\ 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: W \ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ' N d <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Z Q <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. F <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER H <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. T <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. � <br /> 7. <br /> R p �0 0 0 L)c tj 9 <br /> H Z `°" 3 3 ,55 FtF. <br /> y <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of mc o A ° S o' <br /> knowledge and belief it Is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of all a ;, <br /> Information contained In this application(including any accompanying schedule)and I further declare that I recognize that this > y m ti H <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue i permit. I �,9 a a= > <br /> further accept all liability that may be a result of the County of Burns relying on[his Information 1 am providing in this d y', <br /> application.tot I agree to dkCjermit county S at <br /> n charged with atlministrating county ordinances or other authorized person to have Z g c .r. <br /> access to the above-tle remises at any ble time for the p se of inspection. o u 0 0 <br /> wao�,W„ n•w C1 <br /> 3 A a c O coo rr <br /> OWNER'S SIGNATURE a <br /> c 3 W 3 <br /> ZONING ADMINISTRATOR_ v`m G-" lt�C/; <br /> TOWNSHIP PERMITS MAY BE REQUIRED n ON n <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCEg S� N v,H <br /> Pe ��;� h� , , I li9aa� . �� g000g <br /> __ T <br />