Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator n o <br /> APPLICATION FOR LAND USE PERMITS a 9. <br /> OWNER aI ` n 1 Il e lei ��_ In �I.. � J� TELEPHONE ' <br /> �l..11/�Vl/ <br /> MAILING ADDRESS � J ad ab U_/,6 14_0 4�_ /) ✓L W L �Z I <br /> PROPERTY ADDRESS 16g IJ 3c3 mak/ni✓L� ✓ 6vt Ln Fred &✓IC- <br /> ' <br /> LEGAL DESCRIPTION <br /> y <br /> 5 <br /> SINGLE FAMILY DWELLING 0 GARAGE/ACCESSORY STRUCTURE ADDITION 0 STAIIRS ❑ o <br /> TYPE OF PERMIT(S): ,d <br /> FILLING/GRADING 0 <br /> CAMPING UNIT 0 BUNKHOUSE 0 59.692(1V)GAZEBO O DECK 0 <br /> STRUCTURE/ADDITION USE: v �-a1L z ' <br /> (H``ome/CabirhL'ommercial Business; Bedroom; Deck; etc.) o P <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN B Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS y I <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 6 I <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. tnsi <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW y ° <br /> BUILDINGS/STRUCTURES (NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, to w <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) I Q <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT3S)TO THE ORDINARY HIGH WATER MARK R <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. o y 'z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES 5, o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. w <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. c <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. r-I <br /> i <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: <br /> r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. z� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER OO <br /> SETBACK AREA. I� <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. Q <br /> 6. <br /> 7. �P7 <br /> '0 °we e 5 <br /> 1 declare that this application(Including any a=mpanying schedule)has been examined by me and to the best of my knowledge X m P o w y <br /> antl belief It Is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of all Information e <br /> contained In this application(including any a=mpanying schedule)and I further declare that I recognize that this information Iam <br /> liability thatgmay be a be Ilresult of thon e County of the Burnett relying of Burned on this informationsin in iniI am providing Iwhether to an this ue a application.ermit. I further <br /> gree to t all n ^U o U 8 ly <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above. 5 rj <br /> described premises at any reasonable time for the purpose of Inspection. <br /> OWNER'S SIGNATURECJ <br /> �,M C (date) Vf e s iy <br /> ZONING ADMINISTRATOR <br /> n <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 8 L o <br />