Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a <br /> APPLICATION FOR LAND USE PERMITS R� <br /> OWNERv Io�//pL' r� C„nr� (�� ZR <br /> TELEPHONE O <br /> l./ d <br /> MAILING ADDRESS 1/7/ 7 e <br /> PROPERTY ADDRESS ' I r1 J� ��7 LR�LJ <br /> / / 0 <br /> o <br /> LEGAL DESCRIPTION �. <br /> 0 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE v� <br /> BUNKHOUSE❑ 59.692(SV)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING A COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o 'n <br /> STRUCTURE/ADDITION USE: - ole 7�IIdln'4 eeylfl-l !/I <br /> (Home/Cabin; Commercial B i ess; Bedroom; Deck; ° <br /> BUILDING CONTRACTOR: Ur <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS 0 0 <br /> WILL BE RETURNED. h <br /> � 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. e <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW o <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, p 9 <br /> AND INDICATE NORTH (N). rrTJ,', <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) W ' o <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK (y <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 r. <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. S m <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 U-1 <br /> NOTE: <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 WHEN ..i U <br /> NEEDED. p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r. J <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n = S1 J <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. � a � <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. I OO <br /> 5, ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. s � � 000un "d <br /> n n ro 333 itn <br /> ti zo .3o n n $ o' _ x <br /> I declare that this application(Including any accompanying schedule) has been examined by me and to the best of my 3 0 <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 1 further declare that I recognize that this <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing In this c q,.,u iw H,`. '_^„`^, a <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have : 8 8 r <br /> �} <br /> access to the above-described pre es att any re/a11y5/)alna/ble time for the purpose of Inspection. Iµ/ O�w�� n <br /> OWNER'S SIGNATURE 9N .� 1 V�*✓ ✓” I _ 1—lD ."'I' 6 G g o 0 o O ~ <br /> nfA D �: mw prn _n C! <br /> W (date) <br /> Ir I II�y <br /> ZONING ADMINISTRATOR 6�n I �Q / �l <br /> TOWNSHIP PERMITS MAY BE REQUIRED C oa <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE H <br /> ptif(6 l- + 1PfwpG _ed kp <br />