Laserfiche WebLink
Burnett�CountV 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER TELEPHONEL G ^ W <br /> 7 iS-sa�- lbfr5 <br /> MAILING ADDRESS L I <br /> PROPERTY ADDRESS N <br /> LEGAL DESCRIPTION j d-- C.5 ✓�� j 3 L� `3�� / A/y.�L k �� S- <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS❑ FILLING/GRADING ❑ CAMPING UNIT❑ T <br /> 9 N <br /> COMMERCIAL BUILDING ❑}� COMMERCIAL ADDITION LICOMMERCIAL ACCESSORY� STRUCTURE❑ _. <br /> STRUCTURE/ADDITION USE: Hobe .� pXY'CG`lrl <br /> f Z <br /> (.,Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: ") G/ Mer / p <br /> 3 � <br /> z <br /> A PLOT PLAN MUST BE PROVIDED ON AN R`/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS r :- <br /> WILL BE RETURNED. <br /> O Q <br /> DIRECTIONS FOR PLOT PIAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n C <br /> 2. SHOW THE LOCATION AND S1ZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, N 4 <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMEW(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM)OF FAKE,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 /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. U <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. ' <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> Pj <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. = D 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. c S' <br /> 4, NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER C <br /> SETBACK AREA. <br /> i ACCESSORY S ED FOR U AN HA PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. > A > nn n > U <br /> I declare that this application(inclua any accompanying schedule)M1a been examined <br /> etl by me tthebest y <br /> knowledgeabelief it <br /> correct and Icknoled Mate responsible <br /> espn rthe <br /> daand accuracy,of all <br /> information contained <br /> in this application <br /> ludinganyaccompanying uM1ul )and <br /> I tintedeclare that I recognize that Mrs <br /> information I am providing will be relied upon by the countyof Burnettt Wisconsin indetermining whe issue a permit. I <br /> further accept all liability that maybe <br /> aresult of County of Barnett relying <br /> on Mrsinfor information Iamprreviding i Mrs <br /> application. Iagree topermitcounty charged with amuntyordinances orother auMonzed person to <br /> C <br /> have access to the above-described pr isesat any reasonable turn fo urposeofinpeQio > <br /> - - <br /> - <br /> N <br /> OWNER'S SIGNATURE <br /> (tla <br /> > 5 - O <br /> ZONING ADMINISTRATOR - <br /> / T m <br /> TOWNSHIP PERMITS MAY BE REQUIRED - <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSLaUBN TT COUNTY I - <br /> ZOMNG _ <br />