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JuI .30 . 2001 10: 12AM No •0229 P • 2 <br /> ,Burnett County 7410 County Road K, No. 102, Siren,WI 54872 office of toning AdmInIstratc r ' P <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNERTELEPHONE x <br /> MAILING ADDRESS <br /> II PROPERTraooREs <br /> LEGAL DESCRIPTION I ( Gov LOST <br /> SINGLE FAMILY DWEL;JNG GA0.AGwC 6SSORY STRUCTURE 0 ADOM IN O STAIRS❑ S <br /> TYPE OF P£RMIf(S)hI^ <br /> I FILLINWGRADING 0 CAMPING UNIT 0 BUNKHOUSE 0 59.602(1V)GAZEBO C1 DECK <br /> R <br /> STRUCTURE/ADDTIION USE; Aoms P <br /> (Home/Cabin; Commercial�Bualnese; Bedroom; Deck; c.) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN BT BE PROVIDED ON AN a W%11 SHEOF PAPER. ANY NCOMPLETE OR ILLEGIBLE PLOT P S <br /> MUkT t <br /> WILL BE RE'T'URNED. 0 ' <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. "� $ <br /> 2 BUILDINGS/STRUCION AND TURES(NB)EOF ALL N <br /> SHOW THE INCLUOiNG DECKS, NPORCHES/A0 MTCAND `L NEW <br /> ER SRUWRESas a .^.- <br /> AND INDICATE NORTH (N). �p J <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILOING(S)TO ALL LOT LINES, (6) BUILDINGS) (al <br /> TO CENTERLINE OF ROAD, (C; BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK (I) <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. w P <br /> 4. SHOW THE LOCATION OF THE W61.6(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANC S <br /> TO BUILDINGS, ROADS.LAKE, LOT LINES. r�T1s H <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TC BE GRADED 00.FILLED. 4 <br /> E. IF SEPARATE PIANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BU%DER, CONTRACTOR, LTC.,T E 3 <br /> PLANS MUST$E STONED AND DATED BY THS OWNER. .e <br /> V) <br /> NOW; BUILDING/STRUCIVRE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHE <br /> NEEDED. <br /> THIS PERMTT IS SU53ECTTO ALL CONDITIONS LISTED BELOW 1 —{ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIRQMENTS WITHIN 6D DAYS OF PERMIT. <br /> C <br /> 2, REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SMORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER G <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARASSISTORAGE ON Y. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 7. <br /> th a a <br /> dedare that tetcelogeule)hubsennamtedyMeedhebetof y knowledge w : ; <br /> vedea <br /> ane belief It <br /> Comae and tvmplau, I edmowledge that I am ref nsible for Me detail and AOCl Of all InI'Dry n P <br /> contained In thio appllwdon(Including artyattomparying otheduh)and I War declare that recognize that this Information I � �; w ' ht <br /> am pmldln9 wlb be raped upon by the County of Berra Wladmslo In d4temdnln9 whether to Ims a Parmlt. I further accept&II e a g 'O 'd <br /> liability that may be a result of the County of 0urnatt relying in Mia Infonneaon i am prerlding In MIS OPPlauldon, I ager a <br /> parent county Officials Chapel with adnlnlstratelg county ordlnantas or Odtar oudgnted Deegn m arye a Lass to the oborre- ,a <br /> desR@ad premia it any r4monsale me For the purpose eF InsPedhon, C <br /> OWNER'S SIGNATV date) $��• <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED w $ <br /> j THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATEISSUANCE <br /> �'le d L4f/a <br />