Laserfiche WebLink
Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS - - <br /> - 6y <br /> OWN�s TELEPHO7/NE v <br /> '7 -h'/.7' /- 79 <br /> PROPERTY ADDRESS <br /> �J 'y .�JJ�P .� S,a�.✓ /(�� 'sh'J7y <br /> LEGAL DESCRIPTION <br /> Cl I <br /> MAILING ADDRESS <br /> TYPE OF PERMIT(S): <br /> ❑Single Family <br /> Dwelling ❑ Garage/Accessory Structure '2l5tairs J Commercial Building <br /> ❑ Addition J Bunkhouse ❑ Filling/Grading J Commercial Addition a <br /> ❑ Deck J 59.692(ly)Gazebo J Camping Unit ❑ Commercial Add.Structure ;F <br /> STRUCTURE/ADDITION USE - z <br /> / ((Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: <br /> n <br /> r 3 <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. _ ss <br /> ***REQUIRED PLOT PLAN INFORMATION*** - <br /> ❑ 8'/p"X Il"SHEET OF PAPER DISTANCE(IN FEET)TO o <br /> J DRAWN TO SCALE OR DISTANCES LABELED J WELL <br /> J PROPOSED BUILDING/STRUCTURE LOCATION J SEPTIC TANK&DRAINFIELD <br /> 4[imensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED <br /> ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc.) CENTERLINE IF NOT SURVEYED S <br /> 4Dimensions&Heights J ALL PROPERTY LINES o <br /> J NORTH ARROW ❑ ORDINARY HIGH WATER MARK - ) <br /> I] ALL WETLAND AREAS 1�� t <br /> NOTE: Building/structure location must be staked!for onsite verification when needed. t""pp9 ��\ ° U, <br /> THIS PERMIT IS BUBIECT TOALL CONDITIONS LISTED BELOW: — U1 <br /> • Removal or cutting di trees and vegetation is are allow along shoreline <br /> • No structures iincluding retaining walls,etc.)are allowed unless specifically permitted <br /> • No filling,grading,or shore land alterations are allowed unless speciFlcally permitted _ <br /> • Driveway must meet width requirements within va days of permit - <br /> • Accessory e used for human <br /> permits allow for private residential storage only F <br /> "Not to be used for human habitation or rental 4orage** <br /> Ideclare thathi <br /> [ s application(including any accompanying schedule)has been examined by me aM to the best of my knowledge and <br /> this.R is arum correct and myimplans <br /> oemim I yang schedule) <br /> that I am responsible for the detail and accuracyofi all Information contained in Q <br /> rail application he county <br /> any azwmpanying seM1edule)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 /> reshBdf the minitCounty or Burnett relying on this Information l am providing in this application. I agree to permit county officials charged S <br /> with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable <br /> time for the purpose of inspection. - - <br /> >n <br /> Ra <br /> _ _ <br /> ' <br /> ---ADDITIONAL CONDITIONS— r. <br /> p �C��Od� u_ <br /> MwSf E-�✓fLand OFefE"R E'�AioN u�.v7-RuL �'�/G��. __ <br /> JUL 252014 sa <br /> OWNER'S SIGNATURE B-k�NW >'p <br /> n mno m <br /> ZONING OFFICIAL <br /> o? o or <br /> --TOWN/UD[PERMITS MAYBE REQUIRED **THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE _ -You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <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 con miction that violates the law or other penalties or costs. For more Information visit the Department of Natural Resources - <br /> wedands identification web page or contact a Department of Natural Resources service center. N - - <br />