Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator P z <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNEn "^V/• IQS ACI 11(41J4 , T�iT t,,,1 E EPHONE 77'� d Ij�i <br /> „' OX <br /> MAILING ADDRESS 3B�a ilku)_ ULmd S_-1-S(A) 67�lr kke, M/l1 5Sr x <br /> 1 W <br /> PROPERTY ADDRESS J_u/„`// i _ � Sf-(-g�Q <br /> LEGAL DESCRIPTION f7/ CA JT' zi _Iq_f 1)0 <br /> `. �I P, (75 51L( I T_L /o r=R I� o CJ 5 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ (ADDITION ❑ DJErCK ❑ GARAGE/ACCESSORY STRUCWRE`( <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO 11 STAIRS LI FILLING/GRADINGK CAMPING UNIT ❑ / <br /> COMMERCIAL BUILDING COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ a `� <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin, U&Mmercial Business; Bedroom; Deck+ktc.) <br /> BUILDING CONTRACTOR: r" <br /> 1 <br /> U _ <br /> A PLOT PLAN MUST BE.PROVIDED ON AN 8 yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) .. ( n <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C O N <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, ,� a <br /> AND INDICATE NORTH (N). ti J I z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) A) P <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. <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. 3 O <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ' N t <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. /V <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> N <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Q <br /> r I' <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> fQ <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ��', 'A S <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 <br /> SETBACK AREA. J <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6.7. <br /> £ <br /> >, aaoro <br /> m a F F7 <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my F c c 3 3 i;• . <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am d � ^ <br /> responsible for Me detail and accuracy of all u m E w <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this a <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I d ?R ii a <br /> further accept all liability that may be a resuk of the County of Burnett retying on this information I am providing In this Q ' �^ w - ro <br /> application. I agree to permit county officials charged w administrating county ordinances or other authorized <br /> access to the above-described miser t any res a time for the u person ro have n <br /> rpose of inspectlon, o o o s9 <br /> W 5 noovo w a <br /> OWNER'S SIGNATUR rt <br /> tom r al rt�j_ <br /> ZONING ADMINISTRATOR_- �" m l <br /> TOWNSHIP PERMITS MAY BE REQUIRED �O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE ' N <br /> � � S000B <br /> �),Z�m�-�- �1ef12� rheciGZB( � �o✓n'-s 'f iUa." c�tAdclv4ah" ,� x <br /> a4-o9 <br />