Laserfiche WebLink
a <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator - <br /> APPLICATION FOR LAND USE PERMITS <br /> a <br /> OWNER 1 1 �c p TELEPHONE 7L H BLS 7_=�'�� O <br /> Gh A 1 0 2,r <br /> 0 <br /> MAILING ADDRESS c—, ra,,4 s b" LU -, 5 K S,4 0 <br /> a' 1 <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION 7ob¢r Es4d 5 �,O l7 c Sm V i a P) 7 AIOOO 55- o <br /> �FR(ni-Y )-Ors Sant 9)S:ABVE5m- # 4b1ZZ6 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK❑ GARAGE/ACCESSORY STRUCTURE I& <br /> BUNKHOUSE❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ ` <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ S <br /> - z <br /> STRUCTURE/ADDITION USE: <br /> a ''R—'TB <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: $eI � 3 <br /> O <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'.h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O y <br /> WILL BE RETURNED. n J <br /> a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. w `..°- <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW 0�_c <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, I o <br /> AND INDICATE NORTH (N). c <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 <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. .� <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES OC <br /> TO BUILDINGS,ROADS, LAKE, LOT LINES. _ <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. c s <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR,ETC.,THE 3 I <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. <br /> THIS PERMIT IS SUBIECi TO ALL CONDITIONS LISTED BELOW: (`vlr��V <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. <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. �O <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. f <br /> 6. <br /> 7. - s D o 0 o n c 0 7 <br /> n .moo B 3 3 c: <br /> � 7,' g � � 3 ' "= "A <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 p � � o � a'o <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all 21 m d ? .� <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that thisc E. D W N <br /> information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I m c w V 90 <br /> further accept all liability that maybe a result of the County of Burnett relying on this information I am providing in this z w 69 <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to <br /> have access to theabove-described premises at any reasonable time for the purpose of inspectio o w ti w f7 <br /> w � ooa <br /> OWNER'S SIGNATURE4 3 A 2 <br /> rt a o <br /> (da stn 9`� <br /> p a c w m <br /> ZONING ADMINISTRATOR AIIG 9 7ni <br /> TOWNSHIP PERMITS MAY BE REQUIRED (� , <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS2( RCOUNTY <br /> NING <br /> tai. t�i. 00000 <br />