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Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator 7 _ C <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER TELEPHONE <br /> � I :_ <br /> PROPERTY ADDRESS <br /> ��d �� <br /> Gt D � oy <br /> tFGAt DFsrR)P <br /> (ON A;2/✓/,510N_r� �, 7/C�I'S97FFScauG£" �F57.L S <br /> cN 71.zrP,'�:G?r1�4?GE Ai-t�lLCtlyb'b ti'�Jl�,'f �7?� w tp p I� y� <br /> 1� 4�sC"t7 I�.� T�-,i 1rr <br /> MAIUNG ADDRESS 720 Lit 1 !3k"cp h-, Line (ciwe''y l)7n) _55D T <br /> TYPE OF PERMIT(S): 1 r <br /> m Single Family Dwelling Q GaageJADDE Sm,Some m e Q Stairs U Commercial Building <br /> 0 Addition U Bunkhouse U Filling/Grading U Commemial Addition @ <br /> 0 Deck U 59.692(1v)Gazebo 0 Camping Unit 0 Commercial A<c.StmGurn <br /> sraucruRFJAoomory USE '� ��-r. �9Etav�Jf•�F'l=t :.�Y- ' a�� 'rt` <br /> ( Catur;Commani Bialrleps;Sediment;Derx;enc) 7 [YI <br /> V) <br /> BUILDING camucraa: <br /> P321- T <br /> PLOT PLAN---INCOMPLETE OR ILLEGIBLE PLOT PLANS M"BE RETURNED. u' s7. <br /> "'REOUIRED PLOT PLAN INFORMATION+`* J IJ1' li 1 <br /> CT RVe•X 11-SHEEr OF PAPER DISTANCE(IN FEET)TO; t7J <br /> � DRAWN TO SCALE OR DISTANCES LABELED ,0 WELL P/- c?"tJ.� p'�-l' 0i <br /> Er PROPOSED BUILDING/STRUCTURE LOCATION ]. SEPTIC TANK&DRAINFIELO;3, ' I ~' <br /> 4Dimensions&Heights 0' ROAD RIGHT-OF-WAY IF SURVEYED <br /> CI EXISTING BUILDINGS/STRUCTURES(I id.des deb,porch,etc.) 4CENTERUNE IF NOT SURVc ED <br /> 4Dlmempons&HeighGC.dU.,tE� p' ALL PROPERTY LINES <br /> 0 NORTH ARROW ORDINARY HIGH WATER MARK <br /> .U' ALL WETLAND AREAS _ J <br /> NOTE: Buikli borpolmac locabm rant to flake"far orwte venficabm when needed. s Ul <br /> THIS PERMIT 15 SUBJECT TO ALL CONDITIONS LISTED BELOW: l L1 <br /> I-- <br /> Reoval ul <br /> mor attng of trees arc vegata.h learned slang shoreline 1 V l <br /> No sm,crv, (m'ludirg refaimcg ovals,etc.)are allowed mida,creoptcalty Pemntted <br /> • No fill inc,gradmg,w shore Idnd alterations are allowed uoess spedflrally permat h] l <br /> • Do.,mix meet NiCt1 recu4er MtNn So ears of permed, <br /> A`aAAmY am"ablgarage cor mis allow for pmWte ra m"I' l sore"Only l <br /> "-Not to 4 used for human habitztan or rental ara9e-- <br /> i 3W- y_ II <br /> 1ih dere Mat inn application Undadlrpany accompanying chedule)has been e+amirob by me and to the beat Of any knoviedge and ` d <br /> .net It a trw,correR am mmplece. 1 acxnowlMge that t am msponybte for[ne detnn and arcurary or all inMmatbn mMaimE In r1 <br /> mts npprodon Oncl Wiry any accompanying r<bMmq all i fuller beware that I r+mpnhe that this information proNeM will be <br /> i rel de upon trr me Camrty dr au.ne[t Wi+mmin in date.minfnp wbaNer to ivue+perm2 I crept an lialoi dy mst may ba A <br /> salt dome Count,trimmen_mtymomm Doth Nrormetlanl pmons Anna,arra,to u.n. - = - V - <br /> tlNorIieourongwanlyoNlnaeceaoromenaumorhtlpercans[o have a¢essmme apo r ^> <br /> ma or me WrWa+ar irupection. <br /> --AmmONALGONDmOeVS OCT 15 2014a ' <br /> BURNETT COUNTY ` I - <br /> j ZONING <br /> ! OHE0.'S SIGNATURE/ I l.v/..QJhMD 1 2 ( j <br /> W <br /> y _ <br /> ZONING OFFICIAL �ia+r•— /O��+ ands,(m ) _ A T_ _ <br /> --TOWN/UDC PERMITS MAYBEREQUIRED -THIS PERMIT SHALL UPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> Ym are resl>NroNe for unpryirg MM state and federal lam cmmmng wrlmuctim,near or an wetlands, lakes, and seams - <br /> Wetlands Mat are not associated MM open Water an be difliNlt to Identify.Fallore to Comply may coat In removal ar modification <br /> d(:ood am ton that NGti the 13W Or aMM aenaltles M1 Gal For rose alcr namn Yost d:e Detainment Of NaWral Re5mfR5 - <br /> iw_7arIQ5 idMb(kACpl Nob Rod cr Contacts CtaallRMrlt 0f NdNrN ReSM6 a r-ryce after. <br /> t <br />