Laserfiche WebLink
9 z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator < P , <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER TELEPHONE <br /> �U✓ C ��NN/�&TT C�Q!/IFSC 'fes o <br /> V p <br /> MAILING ADDRESS 7� /� S <br /> 2/� SNA ✓/1// /�� A/iG1�7A / y J ��� l <br /> PROPERTY ADDRESS �Wy -Zwa� <br /> / <br /> LEGAL DESCRIPTION L/ // �)It,17 ZZ <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTUREk�" <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ vl a <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ c b <br /> STRUCTURE/ADDITION USE: CC..- Z <br /> (Home/Cabin; CommercW Business; Bedroom; Deck; etc.) <br /> c <br /> BUILDING CONTRACTOR: d2 O 3 (�. ,Z 7 <br /> 17 <br /> y <br /> O � <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 r/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS Co p <br /> WILL BE RETURNED. y S <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL 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 tnf 'O <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, U 5 3 <br /> AND INDICATE NORTH (N). v Z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) O o ? <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w R. <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 DRAINFIELD (DF), AND ALL DISTANCES W <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I <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 /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. �! I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: v I �- <br /> A <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. � A-7 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 1 A G <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. G <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER r <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. F <br /> 7. T = ,D, 0 0 o m c O 7 <br /> m K a �cPn�f <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my 3 o S y ' °, 5 w' S <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all m EL d- _'c y <br /> Information contained In this application(Including any accompanying schedule)and 1 further declare that I recognize that this c. a a m '° <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I d g- <br /> a <br /> further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this '� N �„e.-`-'_^r 7 <br /> application. I agree to permit county officials charged h administrating county ordinances or other authorized person to have <br /> access to the above-desaibeduemises at any reaso le time for the purpose of inspection. a <br /> _ y <br /> OWNER'S SIGNATURE - — a m a $ <br /> (date) o a <br /> ZONING ADMINISTRATE <br /> TOWNSHIP PERMITS MAY BE REQUIRED ` C,' <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> PPY� t It fi tGrPr c � �0 617 S/e ve Y'ezec <br /> U � S000S <br />