Laserfiche WebLink
z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g ° <br /> APPLICATION FOR LAND USE PERMITS W <br /> t1- <br /> OWNERTELEPHONE <br /> t_.C) fz c- �fz-�i6s -zz7-? <br /> o <br /> MAILING ADDRESSQ �. 5 <br /> (Z3'7'( &Alboi/A SY .iJ- t kX i'e V.(. Ss'4yr ; <br /> PROPERTY ADDRESS /8S&, SvE«S pD , <br /> LEGAL DESCRIPTION c <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ADDITION CI DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT El <br /> COMMERCIAL BUILDING O COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> 0 <br /> STRUCTURE/ADDITION USE: <br /> (He/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> 03m <br /> BUILDING CONTRACTOR: µ fl (L n <br /> n �L S <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8`h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS a � . <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) tn*f CJS G <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. ^ °' <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, 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) BUILDING(S) ��tt11 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK (YJ w C} <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p (� <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES �: 0 00 <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. ;n i <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE F _ <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. ! 1� <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN -� I (I <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z rt /� <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 0 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 7' 0 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO <br /> OOT—BE USED <br /> nFOR <br /> HUMAN HABITATION. <br /> 6. <br /> 7 ^ � annnnapro <br /> n A C+ O O O N 6 f to <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 0 ':5 R <br /> knowledge and belief R is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all a m ra a <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this c =-, a a Y <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I .� ? < r0 <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. 3 m d > o 0 0 0 0 r) <br /> OWNER'S SIGNATURE `O�� <br /> (date) <br /> o sn a o. n C, _, O <br /> n o = 3 d _ z <br /> = s i �a = <br /> ZONING ADMINISTRATOR Iv " Q :y c ,Ell <br /> S <br /> O A c d o to <br /> TOWNSHIP PERMIT MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE O N N o N o <br /> 0 0 0 0 0 <br />