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i <br /> I <br /> Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER C TELEPHONE <br /> �.-.tSA SCfn.4�CJ� ) I[/—IC — <br /> PROPERTY ADDRESS <br /> LEGAL DESOUPTICN <br /> MAILING ADDRESS <br /> TYPE OF PERMIll v� <br /> ❑ Single Family Dwelling O Garage/Accessory Structure CI Stairs Z1 Commercial Building L <br /> • �. <br /> Addition '] Bunkhouse U Filling/Grading 7 Commercial Addition - �} <br /> ]9.Deck O 59.691 Gazebo J Camping Unit ❑Commercial ACC.Structure <br /> STROCiURE/ADDITIOI USE �a•O K b z k, <br /> (Hon,/CXtm;Ccmmenial Business;Bedroom;Deck:Cu.) <br /> BUILDING CONTRACTOR: �I4'• '+ <br /> Pu„ t Its-. - dig-1 = 1 v <br /> r <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> ? I p <br /> -"REOUIREO PLOT PLAN INFORMATION'^` <br /> '� 8VI-X I I"SHEET OF PAPER DISTANCE(IN FEET)TO' _ <br /> DRAWN TO SCALE OR DISTANCES LABELED 7 WELL <br /> PROPOSED BUILDING/STRUCTURE LOCATION ❑ S'_PTIC TANK&DRAINFIELD <br /> JJ 4Dimensions&Heights D ROAD RIGHT-OF-WAV IF SURVEYED <br /> 'X EXISTING BUILDINGS/STRUCTURES(includes COIN,porcn,etC.) ->CENTERLINE IF NOT SURVEYED -` <br /> iDimensions&Heights D ALL PROPERTY LINES <br /> 1< NORTH ARROW 7 ORDINARY HIGH WATER MARK = IU <br /> ❑ ALL WETLAND AREAS If I <br /> NOTE: 60ficilg/st-arure IppaSor.must be shied for cal verificil when needed. i <br /> THIS PERMITIS SUBJECT TO ALL CONDITIONS LISTED BELOW MRemoval orattl g f trey arq ego•Jon Is last-IneG along snorelieNo gructu- s(MIC.g r.No"� Ens a c) re I ttN et sPer.L.dy perm. -qNo Ning g ad ng o there ICT. atb s a e plowed ss speoflcalb,OnfecteAUG 2 9 2014 I/ ',T <br /> Orveway n s act vidth rep Cmc is m n 68 days of gamut <br /> Accessory,st-uCtiumfgarage permits allow for ornate resicen;Iai storage only gURNETT COUN1 = U, <br /> "Not to oe used for human reiteration tation rental storage- <br /> I declare Oat this a application(including s n � <br /> pp ( pony accompanying um resp)M1as been wminetl Ey me and to Oe owlMge d In <br /> thisbell applicator it is Inue,wrreR dgE complete. I yles sche Ale)o I am rther sicla Ion Oe I e011 anE•Oat t y of all marmation COntalnin In <br /> rMs nbye Countyding any Bureau <br /> Wast ny schedule)e)an I further aKlva tl a I rmit. I Wt this Information lial i ,Oat !will Ee <br /> ,radial..I'upon by Oe County o(t irel Wisconsin InusionI.determining whether In Islas a garb. I NrOb accept air Opility Nat maybe a <br /> with <br /> of Ne CWnty of Bumettlevencgo or <br /> surnamed arsons have thisapplication. <br /> premises at any re NagM E <br /> clad for <br /> purpose <br /> county oction. cos ar atnw auNatlzM persona to have access to Na above-EurtlOM premises at any reasonable <br /> timefor Me purpose alimpettion <br /> ---ADDITIONAL CONDRIONS--- 9 <br /> y R ?7 <br /> g <br /> �%-�' r1C>_ 2ktS� u.r; p£CI= 54'M1•c s:z� rNI.,D JH�'t PC. > <br /> - AlloWd per 3o-siz(09 <br /> = x <br /> 1\\t\ <br /> OWNER'S SIGNATURE (II!A' •AcaR \�t�` \t <br /> ZONING OFFICIAL� ZO/ ;2 <br /> (e te) <br /> -TOWN/UDC PERMITS MAYBE REQUIRED -THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE ' <br /> You are respeari IN complyng ooh Vote and (Metal It,,arn:e-Nng Consencton near or an efords, IakPS, and Neam,. <br /> wetlands mat are not associated Aim open.rater can be difficult to derVt7 Failure to comply may result in removal or modification 3 <br /> of C."un ion mat vidates me lav,or other penalties er costs. For more information visit the Department of Natural Resources „��v,:S <br /> wetlands Icen fagooc wall page w CIInlact a Department of Natural Resources service Center. <br />