Laserfiche WebLink
c <br /> Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g 3 <br /> APPLICATION FOR LAND USE PERMITS y: �i y <br /> OWNERTELEPHONE ��S-�(n�� q6 <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS Cn , <br /> o (� <br /> n <br /> LEGAL DESCRIPTION Ng /+GS- tV Ex 33 1S-1,4o /6 0 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ m <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ rlwCOMMERCIAL BUILDING COMMERCIAL ADDITION COMMERCIAL ACCESSORY STRUCTURE 11 _c <br /> XX modular Acme- On ub-1k 1tt zSTRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) uJi ) 1 [ <br /> BUILDING CONTRACTOR: A� NDI'Y)eS OSu <br /> y <br /> b 2b <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 rh X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS z o_ <br /> WILL BE RETURNED. e <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 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, Q R <br /> AND INDICATE NORTH (N). N I o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S) TO ALL LOT LINES, (B) BUILDING(S) g o <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK tom. <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES q O <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. F, <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. -. G <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 <br /> NEEDED. <br /> r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> n i <br /> A � � <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. r� z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. y� U, <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 O D <br /> SETBACK AREA. b <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. u' <br /> NOT TO BE USED FOR HUMAN HABITATION. o <br /> 6. <br /> 7. s ;0 Do 0 o Oa0i'0 <br /> 6 n <br /> H <br /> I declare that this application (including any accompanying schedule)has been examined by me and to the best of my g o 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 a a m N : <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I 5 „ ? k= a <br /> > <br /> further accept all liability that may be a result of the County of Burnett relying on this information 1 am providing In this <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have : col- <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. w S «.,ti"A rj <br /> n <br /> 0 <br /> OWNER'S SIGNATURE / /"�O.C�-Q- �n' �/ o 0 o O <br /> mr� �, „ <br /> (date) _ n N Tg T. <br /> ZONING ADMINISTRATOR V 1 r 1 Ij�17�(NYn <br /> nn �. <br /> yXla °cw o n tr9 <br /> C n <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> � � S0000 <br />