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W r <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator °& L-+ <br /> APPLICATION FOR LAND USE PERMITS y 'd <br /> e <br /> OWNER `h 32 JV <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION <br /> o t 99j Lr((.WRb� ' 0 ' <br /> MAILING ADDRESS Lil Z 3 2 :D U<e DRQ <br /> TYPE OF PERMIT(S): S rn <br /> O Single Family Dwelling ❑Garage/Accessory Structure O Stairs O Commercial Building . <br /> Q Addition ❑ Bunkhouse O Filling/Grading O Commercial Addition —1 <br /> Deck ❑59.692(1v)Gazebo O Camping Unit O Commercial Acc. Structure <br /> STRUCTURE/ADDITIONUSE: .�}7- bIZA 6'�,'?"16 �G/ITIa !it✓�J/n/b SEfiSQN/311y) o <br /> Qbme/Cabim Conilyiercial Business;Bedroom;Deck;etc.) <br /> BUILDING CONTRACTOR: <br /> n <br /> b <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS MaU BE RETURNED. <br /> ***REQUIRED PLOT PLAN INFORMATION*** _ g <br /> ❑ 81/2"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: d <br /> ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD w <br /> ->Dimensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED N <br /> ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch, etc.) 4CENTERLINE IF NOT SURVEYED g t <br /> 4Dimensions&Heights ❑ ALL PROPERTY LINES <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK 3. <br /> n <br /> ❑ ALL WETLAND AREAS <br /> o <br /> NOTE: Building/structure location must be staked for onsite verification when needed. 9_6 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • Removal or cutting of trees and vegetation is restricted along shoreline <br /> • No structures(including retaining walls,etc.)are allowed unless specifically permitted <br /> • No filling,grading,or shore land alterations are allowed unless specifically permitted <br /> • Driveway must meet width requirements within 60 days of permit <br /> • Accessory structure/garage permits allow for private residential storage only eo <br /> **Not to be used for human habitation or rental storage** r? z <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and Zi <br /> belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information contained in <br /> this application (including any accompanying schedule)and I further declare that I recognize that this information provided will be <br /> relied upon by the County of Burnett Wisconsin in determining whether to issue a permit I further accept all liability that may be a <br /> result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged <br /> with administrating county ordinances or other authorized persons to have access to theesEC-PENE <br /> a <br /> 1 - I able <br /> time for the purpose of inspection -1` ^` <br /> vF, JJ I n � F9i e <br /> -ADDITIONAL CONDITIONS— 1 ` �L ` ! �� r�r z�(� d�/� rn cr� ty <br /> �. <br /> MAR 22015 <br /> me a r: <br /> �} - -- <br /> 9-9 : 4 < : : <br /> BURNETT COUNTY s. i b <br /> ZONING s a <br /> CL 000$ $ ►� <br /> OWNESIGMA 2'"/5 Z r'/' Cd .,y "'� <br /> ZONING OFFICIAL ZD�j 'e S <br /> orate) C <br /> **TOWN/UDC PERMITS MAYBE REQUIRED "THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE A 5' <br /> You are responsible for complying with state and federal laws Concerning construction near or on wetlands, lakes, and streams. 00 <br /> Wetlands that are not associated with open water can be difficult to identify.Failure to comply may result in removal or modification `? <br /> of construction that violates the law or other penalties or costs. For more information visit the Department of Natural ResourcesC5u <br /> wetlands identification web page or contact a Department of Natural Resources service center. ^ ^o c,®o $ <br />