Laserfiche WebLink
C C <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS 14. y <br /> OWNER <br /> )) µ1 <br /> W <br /> Te e(Piscf /✓/1 io'nne 4U TELEPHONE Orr2 '�Id �7�0 0 <br /> MAILING ADDRESS <br /> uy4l e4 AA L J.1%i�/a <br /> PROPERTY ADDRESS <br /> 30ooy <br /> LEGAL DESCRIPTIONI^ <br /> S -27 T W IV RU w M)nn6�.0 IdA f/�t /aj ,?X <br /> TYPE OFPERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION❑ DECK❑ GARAGE/ACCESSORY STRUCTURE Pr o <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ S' <br /> STRUCTURE/ADDITION USE: C7Z7uc'!g2 Z8�X 3G s'/�'�' �X/8i fj �u»K&we 17 X Z8 CAf/ <br /> c o <br /> ( <br /> H <br /> om(TCabin <br /> ;Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS 0 0 <br /> WILL BE RETURNED. _ c <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. [ O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW 0 <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, .o <br /> AND INDICATE NORTH(N). <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 C <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS, d <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES W <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. S. .7✓ <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. y 1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE (1 , o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. r^ , <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 1 W� <br /> NEEDED. "'i 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 5c r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Q <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. _ (� d <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. " I <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. E <br /> 7. z D0 0 o L) a0 '0 <br /> gn yEl SS � <br /> h Zrt m El <br /> $ <br /> o o <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 9 a 6 <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this _. D W <br /> information I am providing will be relied upon by the County of urnett Wisconsin in determining whether to issue a permit. I ^' _?c' a = 00 <br /> > <br /> further accept all liability that maybe a result of y the mof urnett relying on this information I am providing in this d, <br /> 5. <br /> application. I agree to permit county officials cha ed. ith a inistrating county ordinances or other authorized person to <br /> have access to the above-deuribed premi at y reasons a time for the purpose of inspection. m > w s9 A <br /> OWNER'S ,� (/pe 3 A o g o g o y <br /> SIGNATURE G �� Il'-� L'�� i ` a W n 6 = 0 <br /> te -�.) n e n <br /> ZONING ADMINISTRATOR lim F l Qno� <br /> m <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> io 0 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> Pevm;+- 41o_f4e�­pfcod otp6gj t%%p <br /> � � s000 � <br />