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Burnett County 7410 County Road N,No. 102, Siren,WI 54872 Office of Zoning Administrator Cr <br /> _ C <br /> APPLICATION FOR LAND USE PERMITS 70 <br /> k <br /> OWNER TELEPHONE �� �� � ��� o atherine �narrlh �i`��to-�uhy <br /> PROPERTY ADDRESS If�'2�I �^„L�/_ ) AW O—� f ("9 <br /> oA) OF — <br /> LEGAL DESCRIPTION X07 116 DAY,TAI"P V- KA�o M ON <br /> r ^ <br /> MAILING ADDRESS 1$44 SumfArr 1. 6T PAot., HO -56 toy _ <br /> ( <br /> TYPE OF PERMIT(S): �/ <br /> U Single Family Dwelling pL Garage/Accessory Structure 0 Stairs U Commercial Building - <br /> U Addition U Bunkhouse 0 Filling/Grading U Commercial Addition <br /> U Deck //EIiUlf p5y9E.6/9t2(ly)Gazebo 0 Camping Unit U Commercial Add.Structure <br /> ted <br /> STRUCTURE/ADDITION USE: e, r <br /> (Mome/Gbin;Commercial Business Bedroom; Deck etc.) 7 <br /> BUILDING CONTRACTOR: 1„ <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. _ — <br /> ***REQUIRED PLOT PLAN INFORMATION*** - J <br /> :J 81h"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO <br /> 0 DRAWN TO SCALE OR DISTANCES LABELED U WELL t, <br /> U PROPOSED BUILDING/STRUCTURE LOCATION 0 SEPTIC TANK&DRAINFIELD <br /> -)Dimensions&Heights 0 ROAD RIGHT-OF-WAV IF SURVEYED <br /> U EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc.) CENTERLINE IF NOT SURVEYED = � <br /> 4Dimensions&Heights U ALL PROPERTY LINES <br /> U NORTH ARROW 0 ORDINARY HIGH WATER MARK - Qf <br /> 0 ALL WETLAND AREAS <br /> �r IR U') <br /> NOTE: Building/structure Id ion must be staked for onsite winflcatim when needed. ^ <br /> THIS PERMIT I5 SUBJECT TO ALL CONDITIONS LIStED BELOW: ESE'I•• ❑Are] iRemoval a cutting T trees CO vegetation is restrittetl along shorelineNo structures(including retaining walls,etc.)are allowed unless speaficaPy permittedNo filling,grading,or shore land alterations are allowed unless specifically permitted <br /> Driveway must meet width ree,uirements within 6o days of permit Accessory structure/garage permits allow for privte residential storage only iu <br /> "Not to be used for human habitation or rental storage" _, a <br /> I declare Mat this application(including any accompanying schedule)has been eaamiinetl by me and to Me be g n , <br /> btlier it is We,contract aha complete. I acknowledge Nat Is <br /> respmsible for the tleGil and accuracy of all entainod <br /> chis application(irc u ffng any accompanying schedule)and 1 IUMo-detlare that t recognize Mat this infamutian pmv W d will be <br /> relied upon by the county or Burnett Wisconsin in determining whether to issue a permit I further accept all liability that may b,a <br /> result of the County of eumett relying on this information l am providing In this applio[Ion. l agree to permit county officials charged <br /> With administrator,county oNi,unces or other authonzM persons to have access M Me above-describN premises at any,reasonable <br /> time for purpose of instruction. _ <br /> _ y Fr L _ <br /> ---ADDITIONAL CONDITIONS--- %. 3 y <br /> ALL SETB rtcKS w)u5T BE ngEET, ZNczu r9SNGa TryE to <br /> SETBrkK Ta THE Sou-i /-OT <br /> E)cZ5TZ7VG, 81x/z' SHED /v1uST QE MOvEd so 27 <br /> S�T3AcKs BY o�iois - � _ - - _ <br /> OWNER'S SIGNATURE � yj -= 000 _ <br /> 9 zit Zo/ - <br /> ZONING <br /> OFFICIAL <br /> (date) <br /> --TOWN/UDC PERMITS MAYBE REQUIRED '*THIS PERMIT SHALL E%PIRE ONE YEAR FROM DATE OF ISSUANCE ' <br /> You are responsible to ror mmptying with state aha federal laws maeming construction near a on wetlands, lakes, and streams. <br /> Wetlands that are t assaaated pe <br /> with on water can be difficult to identify. Failure to Comply may result in removal or modlfiotbn <br /> of construction that violates the law or other penalties or casts. For more Information visit the Department of Natural Resources c <br /> wetlands identification Department <br /> web Page or bontact a of Natural Resources servete center c <br />