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Burnett County 7410 County Road N,No. 102, Siren,WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS y d <br /> a c <br /> OWNER Glenn Dodott TELEPHONE 715-8664780 <br /> MAILING ADDRESS 4724 Mallard Lake Rd Webster WI r A <br /> PROPERTY ADDRESS 6716 Old A Webster WI - <br /> n R <br /> LEGAL DESCRIPTION — <br /> TYPE OFPERMIT(S): SINGLE-FAMILY DWELLING ADDITION DEC( GARAGUACCFSSORY STRUCTURE <br /> N <br /> BUNKHOUSE• 69.692(1V)GAZEBO STAIRS FILLING/GRADING CAMPING UNIT � <br /> COMMERCIAL BUILDING X COMMERCIALADDITION COMMERCIAL ACCESSORY STRUCTURE _ <br /> STRUCNURE/ADDITTON USE: storage units add,bon <br /> (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) o - <br /> BUILDING CONTRACTOR: Northland Builders Incryry �;7 <br /> HTXlt �P-SS ±ka' 5()/d ll.Jn:Cpn- ml�/Y ��C2 <br /> A PLOT PLA MUST BE PROVIDED ON AN 8'A X11 SHEET OF PAPER. ANY IN +COMPLETE OR ILLEGIBLE PLOT PLANS C 3 <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) — <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. M o <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, rTJ <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) r° <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 O <br /> TO BUILDINGS,ROADS,LAKE,LOT LINES. =lAJ1 <br /> S. 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 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. c �y <br /> W <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE GONE WHEN ll I y <br /> NEEDED. r I <br /> d <br /> THIS PERMIT IS SUBIC{T TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN W DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n Z <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. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. 3 ? c nR 'apLT* <br /> R 3 3 'S > X <br /> ano tele that this corHoehn d coo fete.ng l aoam riedge that lam <br /> respon ibl examined by me amil nd accu the best of my kaowl'tlge 3 1 : . <br /> and belief It istrue,correctani Wi"a. IabkmMnyi MatLamrasponsiblefor Medefaiial accuracypallinformation m :�=e. <br /> mnbined in Misapplkation(inctedilq anY armmpanyim acAedule)aedlNMer tledare Mrtlremgnize that His inbrma[bna D <br /> am prmiding will be relietl upon by the County of Someet Wisconsin in determining whether b home a permit I brther arrant all _ � g c Z <br /> liability that may be a remk of the County,of eumett relying on this information l am proridinP in this application. T agme to _ �6, t' <br /> Permit county onklals charyed with administrating county ordinances or other authorized person to have access to the above- <br /> described premises at arty reasonable time for the purpose of Inspection. 6 }a v c i <br /> yc <br /> OWNER'S �. n�r/ c� > Can� m_. 0 <br /> SIGNATURE 6/9/2014 <br /> � nc <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED ? <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE U 8 0 0 0 8 <br />