Laserfiche WebLink
Burnett County 7410 County Road K,No.102, Siren,WI 54872 Office of Zoning Administrator g t" <br /> b <br /> APPLICATION FOR LAND USE PERMITS y. N <br /> OWNER <br /> Kelly TELEPHONE Ne�g,-en �7.asg-a//1 <br /> PROPERTY ADDRESS <br /> j O <br /> LEGAL DESCRIPTION d <br /> Gr / k klc S/lp(GS �O Z, <br /> w <br /> E <br /> e <br /> MAILING ADDRESS fay E S+�ei�r/4n 5?. nnQ�► TG lls rnAJ. z�9 <br /> c <br /> TYPE OF PERMIT(S): , <br /> ❑ Single Family DwellingGarage/AcceS M$t ixulre__-U3�tairs ❑Commercial Building =. <br /> ❑ Addition 4Bunkhouse ❑ Filling/Grading ❑Commercial Addition <br /> ❑ Deck ❑59.692(iv)Gazeta ❑Camping Unit ❑Commercial Acc.Structure <br /> r _ <br /> STRUCTURE/ADDITION USE: z <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) 's1 ° <br /> BUILDING CONTRACTOR: S¢I- O <br /> � n <br /> n <br /> PLOT PLAN---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. m o <br /> ***REQUIRED PLOT PLAN INFORMATION*** rM E <br /> ry <br /> W"81h"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: a <br /> 01111"DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> W PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD y <br /> 4Dimensions&Heights ROAD RIGHT-OF-WAY IF SURVEYED o <br /> EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc.) CENTERLINE IF NOT SURVEYED ' <br /> 4Dimensions&Heights ALL PROPERTY LINES o <br /> be-NORTH ARROW ❑ ORDINARY HIGH WATER MARK S. <br /> ❑ ALL WETLAND AREAS <br /> NOTE: Buildingilstructure location must be staked for onsite verification when needed. <br /> 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y <br /> • Removal or cutting of trees and vegetation is restricted along shoreline <br /> • No structures(including retaining walls,etc.)are allowed unless specifically permitted <br /> No filling,grading,or shore land alterations are allowed unless specifically permitted <br /> • Driveway must meet width requirements within 60 days of permit r <br /> • Accessory structure/garage perrnits allow for private residential storage only <br /> **Not to be used for human habitation or rental storage** r <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the beet of my knowledge and <br /> belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all info nnatlon contained in <br /> this application(including any accompanying schedule)and I further declare that I recognize that this information provided will be <br /> relied upon by the County of Burnett Wisconsin In determining whether to issue a permit I further accept all liability that may be a <br /> result of the County of Burnett relying on this information I am providing in this application. I agrees to permit county off Idals charged <br /> with administrating county ordinance,or other author vad persons to have access to the above-described premises at any reasonable <br /> time for the purpose of inspection. <br /> T ry 0 0 0 r.1 p d <br /> --ADDITIONAL CONDITIONS--- fsm c R <br /> 5 <br /> E. tZe.P: ir: <br /> ?c a <br /> N ri7m N <br /> N L�?7y <br /> O O O M^f <br /> OWNER'S SIGNATURE <br /> (date) <br /> Mi; c_` � g g 0 `-by <br /> ZONING OFFICIAL h a 5 c <br /> ' V <br /> c e w 0 <br /> (date) <br /> n CC <br /> **TOWN/UDC PERMITS MAYBE REQUIRED **THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <br /> Wetlands that are not associated with open water can be difficult to identify.Failure to comply may result in removal or modification <br /> LA t2o <br /> of construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources �" <br /> wetlands identification web page or contact a Department of Natural Resources service center. <br />