Laserfiche WebLink
z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS <br /> su <br /> OWNER - TELEPHONE 715-8bh-�9q5 d <br /> MAILING ADDRESS z2 lj 1A�8,� 'io goo 01 <br /> 1,)oh^-`teri �� ° <br /> PROPERTY ADDRESS /�� •(� IA,[ )�,J`,�_ Z[ ,0j <br /> LEGAL DESCRIPTION o v <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECKX GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING O CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION COMMERCIAL ACCESSORY STRUCTURE ❑ o � <br /> STRUCTURE/ADDITION USE: E� Z <br /> 0 <br /> (Home/Cabin; CommerFial Business; Bedroom; Deck; etc.) I — (� <br /> BUILDING CONTRACTOR: n U,I <br /> O < <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS G o <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) to Cl p <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. h n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW to o <br /> BUILDINGS/STRUCTURES (NE), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, OO b <br /> AND INDICATE NORTH (N). N z <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. O _ <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST) AND DRAINFIELD (DF), AND ALL DISTANCES 9. <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. 3 m <br /> 5. 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 4 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. i <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Cj <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. P.. <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. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. svkje&, +DSS.+e Plan A-pprova,lT�afoicrz c cu.ft. <br /> 7. 30J°t3d 3 �7a000 �a �° � <br /> R � R333 �' a - 7y <br /> o ry rt a S <br /> [declare that this application(Including any accompanying schedule)hes been examined by me and to the best of my m o Z = R � <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 m N <br /> Information I am providing will be relied upon b the County of Burnett Wisconsin In determining whether to Issue a permit. I °' ^ ii u <br /> P 9 Do Y ty 9 5 „ . 00 < b <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 � "o `_^N,..� o r <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized Person to have w S e 8 0 <br /> access to the above-described premises at any reasonable time for the purpose of inspection. ° <br /> W 's7m ° 8�" 8 > <br /> ( 8 <br /> OWNER'S SIGNATURE ( ate) n 5117Z0 `A a r) <br /> C.=: <br /> o ? c o <br /> ZONING ADMINISTRATOR <br /> yPC : m 'm R7 <br /> TOWNSHIP PERM S MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> ,n �i' goo � 8 <br />