Laserfiche WebLink
c <br /> Burnett County 7410 County Road K,No. 102, Siren,WI 54572 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> o a <br /> OWNER TELEPHONE <br /> m rt vane refz <br /> 0 <br /> MAILING ADDRESS � ( E <br /> 3 0I y6fti <br /> PROPERTY ADDRESS I o <br /> K 3 <br /> LEGAL DESCRIPTION ti <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION t% D CK❑ GARAGE/ACC 55 R UCTURE❑ .o.QS <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO❑ STAIRS ❑ FILLING/GRADING❑ CAMPING UNIT❑ ; <br /> 0 <br /> Z <br /> Z <br /> COMMERCIAL BUILDING❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORYSTRUCTURE ❑ <br /> �v / GI <br /> STRUCTURE/ADDITION USE: e(� Q" d � 1 <br /> ome a In;LOmmercial business; a room; eC ;etc.) <br /> n h <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLAITS O <br /> WILL BE RETURNED. I O 3 <br /> n w 9-1 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) C <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 [n c i <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) <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 <br /> TO BUILDINGS,ROADS,LAKE, LOT LINES. a , <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. �p <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE V' <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEII O <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: n I c G <br /> ' z C" C <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. f z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. , <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. O G <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER C <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. :E <br /> 6' ^ � annnnaoro <br /> on 3 3 3 c Cil <br /> 7. <br /> El El <br /> o ry o <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my Y m $ ! y <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all d a a 'c_ : Y <br /> Information contained in this application(including any accompanying schedule)and I further declare that I recognize that this c S FL°O " ' 'V <br /> ,s <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I p N : -f2 o -00 <br /> further accept all liability that may be a result of the County of Burnett relying on this Information I am providing in thir <br /> s g y o <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. n o o y <br /> OWNER'S SIGNATURE - /�*^ & "'� �� L. n Ra? <br /> (date) c <br /> ZONING ADMINISTRATOR <br /> n <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE "N = <br />