Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator — Z <br /> APPLICATION FOR LAND USE PERMITS E- <br /> P <br /> ` UJN <br /> � C W <br /> OWNER , ( TELEPHONESCO <br /> TC ` �U_ C9 � V •VJ <br /> A <br /> MAILING ADDRESS 2-0 C 0 b� S`.pQJ <br /> V U V , <br /> PROPERTY ADDRESS (1j <br /> .� <br /> LEGAL DESCRIPTION M <br /> SINGLE FAMILY DWELLING ❑ GARA /ACCESSORY STRUCTURE ADDITION ❑ S A[RS ❑ o 0 <br /> TYPE OF PERMIT(S): w �^ <br /> FILLING/GRADING O CAMPING UNIT, O BUNKHOUSE O 59.692(1V)GAZEBO O D CK O Imo' 3 ? <br /> STRUCTURE/ADDITION USE: t U — Y <br /> (Home/Cabin; Comme tial siness; Bedroom; Deck; etc.) o P <br /> BUILDING CONTRACTOR: I <br /> I_ C <br /> A° <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET, F PAPER. ANY INCOMPLETE OR ILLEGIBLE PLO PLANS m H 4. <br /> WILL BE RETURNED. x ('h <br /> < �I <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP OEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TOE SHOWN OR DRAWN TO SCALE. trvl -s) O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTIN� BUILDINGS/STRUCTURES (EB)AND ALL NEW r <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DEC S, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUIL ING(S) r <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUAEMENT(S)TO THE ORDINARY HIGH WATER MA K C 3 <br /> (OHWM) OF LAKE,STREAM OR RIVER AND WET4ND AREAS,AND(D)LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL (W), SEPTICJANK (ST)AND DRAINFIELD (DF), AND ALL DIS ANCES w c <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. m <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNEqqAND SHOW AREAS TO BE GRADED OR FILLED. .� <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCf ITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE _ O <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. — <br /> ti f <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. _ <br /> O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BE�OW: 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n s. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. & <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLSI ETC.,ALLOWED WITHIN THE REQUIRED WATE I� p <br /> SETBACK AREA. �. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGEISTORAGf ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. F <br /> 6. <br /> aoe <br /> n C o R <br /> 7. <br /> no <br /> 3 �,°Zm : aw <br /> I declare that this application(Including any accompanying uhedul )has been examined by me and to Me best of my knowledge c� Z •r.� <br /> and belief It is true,correct and complete. I acknowledge that I a responsible for the detail and accuracy of all informati o _ <br /> contained in this application(including any accompanying schedule and I further declare that 1 recognize that this informs on I Y <br /> am providing will be relied upon by the County of Burnett Wisconsi In determining whether to Issue a permit I further accept all <br /> liability that may be a result of the County of Burnett relying on thi Information 1 am providing In this application. I agree to Un'~F r• <br /> permit county officials charged with adminlstra ggqg coyyntY ordina or other authorized person m have access to the abo e- <br /> described premises at any reasonable time for rye drpose of Inspe�tion. m n L s T y <br /> J t V O <br /> R .A <br /> �-� <. <br /> OWNER'S SIGNATURE � o n i S': c c.=' 2 <br /> _ c (date) H . u w' <br /> ZONING ADMINISTRATOR � lay <br /> t <br /> TOWNSHIP PERMITS MAY BE REQUIRED «_ ! <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> per5ceN- + eel `f-3-b� <br />