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Jul 30 10 03:37p Ross Wylie 715-259-7506 p.1 <br /> n <br /> Burnett County 7410 County Road K, No. 1132, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS v t <br /> OWNER TELEPHONE g <br /> v�G I l (�loen � I R <br /> MAILING ADDRESS b2.902I-C) Tr-TrS61,re...Ista id CTL L .n b�s�l� •,7Gf /� Q(i o <br /> n <br /> PROPERTY ADDRESS <br /> 29Gdo TrEc1u�E slant( C' <br /> L' <br /> LEGAL DESCRIPTION 'z::) � <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION Cl DECK GARAGE/ACCESSORY STRUCTURE 0 Q <br /> BUNKHOUSE C 59.692(1V)GAZEBO C STAIRS 0 FILLING/GRADING CI CAMPING UNIT D a (� <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION CI COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITION USE: Z $ <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) y.. Sb <br /> BUILDING CONTRACTOR: lie- 1} I nav— Relr?o „ efiYl <br /> o � <br /> A PLOT PLAN MUST BE PROVIDED ON AN 81 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. ., <br /> DIRECTIONS FOR PLOT PLAN DRAWING: CARIAL OR TOP VIEW) m a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE, <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW m I'' o <br /> BUILDWGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, �0 9 <br /> AND INDICATE NORTH (N). z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) O. <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. I � � <br /> 4. SNOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST) AND DRAINFIELD(DF), AND ALL DISTANCES O <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. rr <br /> S. INDICATE IF A WALKOUT BASEMENT 15 PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE C WNER. <br /> Qj <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. VI <br /> 5 1 i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r- <br /> C y. <br /> I. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 6C DAYS OF PERMIT. <br /> 2. REMOVAL CR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. O is z 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. (IJ <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. "1 <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. T 'b r>i f)o za0b <br /> I declare that this application (including any accompanying schedule)has been eamined by me and to thebest of my 3 0 a $ F, m' <br /> knowledge and belief It Is true,correct and complete. I admowledge that 1 am responsible for the detail and accuracy of all o w ==a H <br /> Information contained In this application(including any accompanying schedule)and I further declare that I recognize that this a 9.>> c N : 9 <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permR I <br /> further accept all liability that may be a result of the County of Burnett relying on this Information 1 am providing In this <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to here <br /> access to the above-described premises at any reasonable time for the purpose or Inspection. < q = >o o c p,o ti <br /> OWNER'S SIGNATURE —3 o — -z-c' f O <br /> (date) a ff <br /> ZONING ADMINISTRATOR I�� F�Q�(G,G(n •T ° um' nto <br /> C VP r” <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />