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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LANDUSEPERMITS <br /> B 7 = v <br /> OWNER C 1 lO� �L YIL LA s TEiEPHONE <br /> 4— O <br /> J. <br /> MAILING ADDRESS <br /> T ct ijk;k &9,, <br /> PROPERTY ADDRESS ry✓ �l1 O-^' ' �I ,t I;,, WZ �7d <br /> J/ /f/30 <br /> I 1 <br /> LEGAL DESCRIPTION Coy Ly� Nso^ R4C Uy1`L1 K1q � <br /> L <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION DECK❑ GARAGE/ACCESSORY STRUCTURE <br /> 5, <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 p <br /> STRUCTURE/ADDITION USE: L o <br /> (Noma/(('bin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: Se�T y <br /> O l <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Va X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PIANS x <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <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 �T ' <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). t. <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) w <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK > O <br /> (OHM)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. 1 <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. r� <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE W s <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFTCATTON MY BE DONE WHEN y <br /> NEEDED. S <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: t <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. I A Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. TT G 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. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. � <br /> NOT TO BE USED FOR HUMAN HABITATION. S <br /> 6. <br /> 'Pp >nnnoo m <br /> y' xn R333 � E� A <br /> I dc4re nmt nits awRmtbn(UMW R9 Try a®nPenybq sdr4uk)hn been eambw4 by,me ant to the bW of myg o,z a.a_ .�'w <br /> Ienwhtlge aitl WW R N true,mrrct and oanMete. I ach malulge Nat I am responsible for the dedll and accuracy of all 6 —9 ` = <br /> NNrmalbr,mnp!L in Nb appestbn(IrcidYg any xmrnpanYlnq slrCule)and I NrtNrr deffire Naz 1 rem9n4e UW this E =-n �a u 9 <br /> Inlormalbn Ism MoYdbq will be relieduwn by Ne County of Burrell Whxbnaln In determinhg whetNn to Rvie a permit. I w U <br /> NR adept all IlebdRy Nat may W a r R of the O my of Burrclt relybp an Nb IlWmtatlu�I am pmvBlnp In N6 '^ 5 <br /> appblbn. 1 apree m permit manly nBkleN dlar9m administrating onty ordlnarco or aber alAlortre4 person to have s yw c g r <br /> a as bo the aboe-dasa0d Prenta az arty Li lbne Tar ue wrpose of hrspectbn ' a s n <br /> - oda U�a'g" a <br /> OWNER'S SIGNATURE 0,, - �'Pldt}.._ 7 / 1 <br /> ZONING ADMINISTRATOR_ / 5m ala <br /> OWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS; UA h 2JUL <br /> u <br /> Lj (� BURNETT COUNTY <br /> ZONING <br />