Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER ©\'I / 1 I„ �1 I �y TELEPHONE ! / �`�Iy I a-/ 0 w <br /> MAILING ADDRESS el ('; (7 _I f tf^jt ^ , `f I ri , <br /> PROPERTY ADDRESS S ^ Q <br /> , 1 °< Q <br /> LEGAL DESCRIPTION o <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTUR <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ , <br /> 'v <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITIONUSE: <br /> o + <br /> (Home/Cabin; Com Tal Business; Bedroom; Deck; etc.) O��Gti/ tS G 1 <br /> A <br /> BUILDING CONTRACTOR: y <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS c <br /> WILL BE RETURNED. <br /> `n a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) d <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW ed ' 3 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). o o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) <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 C� <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD (DF),AND ALL DISTANCES <br /> 41 <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. �y <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER, CONTRACTOR, ETC.,THE o <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 <br /> NEEDED. <br /> 90 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r- <br /> I o W <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. B CI <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. OG! <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7 � aa <br /> nnnnporo <br /> n R 3 3 3 k R <br /> FzeAnnSg � <br /> I declare that this application(Including any accompanying schedule)has been a mined by me and to the best of my 3 F, Q c �. <br /> knowledge and bellef It is true,oortect and complete. I acknowledge that I am responsible for the detail and accuracy of all $ m==. <br /> Information contained in this application(including any accompanying schedule)and I further declare that I recognize that this ` > > ° y <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I $ .�^, ?w'v w H 'V <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing In this o '^N: o .0 <br /> application. I agree to permit county officials charged with adminisdatlng county ordinances or other authorized person to have Z g 8: S c � <br /> access to the above-described remises at any reasonable time for the p on of Inspection. m o?w, <br /> OWNER'S SIGNATURE �/ "l�'� (dare) n H c$m Y 6 z <br /> SIU; <br /> ZONING ADMINISTRATOR <br /> iw':: til{m iC�Q✓�(�Q l'� i"' Pt <br /> TOWNSHIP PERMITS MAY BE REQUIRED c <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE V C: <br /> 9�✓vw��-d-l��� �I�� upbr� �Da��eCh���sf�a�, s=as'-� <br /> ��80008 <br />