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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator `g P <br /> APPLICATIONVOR <br /> ) LAND USE PERMITSL '4�4 <br /> OWNER (/'h pn�P� G�/ �( C� TELEPHONE'5-�V 2 <br /> MAILING ADDRESS �UOTUn�A ^ <_So6� JcV u v O <br /> PROPERTYADDRESS ����jl ,Q�/Jlll�/1 TL7 ✓�V�C o�n'/� �" ' <br /> n ( <br /> LEGAL DESCRIPTION (�l <br /> TYPE OF PERMT(6): SINGLE-FAMILY DWEWNG ❑ ADDITION DECK❑ GARAGE/ACCESSORY STRUCTURE S ?_ <br /> BUNKHOUSE ❑ 59.692(IV)GAZEBO O STAIRS FILLING/GRADING ❑ CAMPING UNIT❑ V <br /> C DRY STRU <br /> COMMERCIAL BUILDING [I COMMERCIAL ADDITION ❑ COMMERCIAL ACCTURE <br /> 22 f n —YA, ff�l�• <br /> STRUCTURE/ADDITIONUSE'!cn C^�"L' – J12c•ZZ-e Ltl4' `i/J a7 Z <br /> (Home/Cabin; Commercial Busmes/s�edroom; Deck; etc.) <br /> BUILDING CONTRACTOR: �� SERO C�nS: o;vd <br /> n <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 V.X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PUNS F _el <br /> WILL BE RETURNED. 0 G <br /> T <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> In <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 m v n <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, v <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) p <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. p. <br /> 4. .SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND ORAINFIELD(DF),AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. p' <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 4 -i <br /> 6. IF SEPARATE PUNS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE U <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. L� <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 11vL1'LY_.I <br /> H <br /> NEEDED. � T� <br /> THIS PERMIT IS SUBIECr TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. `(1 n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. w a <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. L <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. £ <br /> 6. <br /> 7 > nnnn> o -z <br /> i 3acg5P <br /> 1 declare that this awflartlon(Including any amomMnying schedule)has been examinecl by me and to Me here M my o,� Q a 3 w $ <br /> knowledge and belief R is tme,mrrcct antl complete. I ackno dqe that I am responsible for the detail and acaracy of all , • m •_= <br /> Inf mmar n mMalned In MIs applltatlon(Including any aPmmpanyIN schedule)and 1 further declare that I recognhe that li >¢v <br /> Infomurdon 1 am provMing Wil be radialupon by Me Gamey M Burrett Wmrm <br /> Hn In deterr ning Wissue hethc to a permit I :5 u C <br /> further amapt all Ilabllity that may be a rt ft of Me County 0 Wmett reNhp on this Infannadon I am PmHding In thin; 6 u'•"^'^ <br /> application. I spree to permit county anneals charged wIM administrating county ordinances or other auMOHzed person[o have C1 g 8 8 8 r <br /> amen to Me abovo-desalbM premises at ble tl e for Me pury9se of Inspeclpn. t w c,�a W M« A <br /> 8.1 <br /> OWNER'S SIGNATUREnn <br /> g s9 �e Ca T. 2 <br /> ZONING ADMINISTRATOR _ <br /> TOWNSHIP PERMITS MAY BE REQUIR P ? 2013 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE <br /> M w 8=^0 8 <br /> "k UNry o <br />