Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator n Z <br /> APPLICATION FOR LAND USE PERMITS <br /> N N <br /> //1 �/1 L p ' I 7 ol�jlp� ,, , / ` I <br /> OWNERI G JVD 1 �1 Sk_)SC �T e I CD✓C, 11� TELEPHONE & sl 7 <br /> MAILING ADDRESS I 'nn / I V�f o 1 JG ' � s I i' <br /> S l <br /> PROPERTY ADDRES \ Lr/�e +�pIIInTTTIII�--�� �/SCOYI <br /> 1 <br /> LEGAL DESCRIPTION jl C <br /> SINGLE FAMILY DWELLING GARAGE/ACCESSORY STRUCTURE 0 ADDITION 0 STA RS 0 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING 0 CAMPING UNIT 0 BUNKHOUSE 0 59.692(1V)GAZEBO 0 DECK 0 <br /> STRUCTURE/ADDITION USE: l4 o m eZ 5� <br /> r o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) S ro <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS G <br /> WILL BE RETURNED. A < <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C h <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, <br /> AND INDICATE NORTH (N). n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILD'ING(S) 3 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK .o <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. o rn z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DIST�NCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. I 00 <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 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. ��������I��I"""""" <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE ryHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> r Z I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ;u O <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n 51j <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. I 8 <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER O� <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGEONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> n rs <br /> 7. g <br /> I IT9 cw w <br /> 1 declare that this application(including any aaompanying schedule)has been examined by me and to the best of my kno ]edge , Z m Sa n y <br /> and belief R Is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of all Informatio o ? <br /> contained In this application(including any accompanying schedule)and I further declare that I recognize that this informa on I <br /> am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further as pt all = N$N U S to <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree <br /> permit county, Marg with administrating county ordinances or other authorized person to have access to the abo <br /> described premises at any re nabde time for the purpose of Inspection. . <br /> _ =mo <br /> ^ —SZ r07 o OSx <br /> OWNER'S SIGNATU (dace) vs g a <br /> Q �o g w ts1 <br /> 'c:: tai <br /> ZONING ADMINISTRATOR .z. <br /> I <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />