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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator - - <br /> APPLICATION FOR LAND USE PERMITS = <br /> OWNER TELEPHONE PC }2/ S Na�p�72 <br /> MAILING ApDRES <br /> po E SS A/e <br /> PROPERTY ADDRESS a 70 ,J n L /3 P/90if �K /Z J/ O/�<(? cri/ <br /> LEGAL DESCRIPTIONSL r a <br /> 1/£ /v S c 3 2- ' N, /? /y 1V <br /> TYPE of PERMIT(S): SINGLE-FA ILY DWELL+i�I Gn�ON ❑ DECK 13GARAGE/ACCESSORY STRUCTURE <br /> BUNKHOUSEEI 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT❑ � <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE❑ <br /> L ? <br /> srpucTuRE/ADDmoN use G Ora gn <br /> �Q (Home/Cabin;Commercial Business; bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: Si%/ I _ e) IyJ <br /> s J <br /> F < <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8`/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O <br /> WILL BE RETURNED. - cF. <br /> n <br /> DIRECTIONS FOR PLOT PIAN DRAWING: (ARIAL OR TOP VIEW) re q <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 Cj _ <br /> BUILDINGS/STRUCTURES(NS), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, �I <br /> AND INDICATE NORTH(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(5)TO THE ORDINARY HIGH WATER MARK C> <br /> (OHWM)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 N <br /> 5. INDICATE IF A WALKOUT BASEMENT 15 PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR,ETC.,THE ECD <br /> PANS.MUST BE SIGNED AND DATED BY THE OWNER, <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN V" y <br /> NEEDED. -�I � � <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I b <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. e <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. i z <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. F <br /> 6. <br /> 7. eA > ^ _ r. n > U <br /> Ideclare eattM1 this its tru ,corre tandcmplete.g any Iackowledle)hat been exaresponsible <br /> esponetlbY meand tothe and <br /> rst of accuracy <br /> 3e ,2 <br /> knowledge and belief i in thise,correQanO(including <br /> yaccompa yin thati schedule)and <br /> Ifu t er leeare that <br /> t I recognize <br /> that <br /> _ v ..] <br /> �- rirormatlon(gnTalnep in this appl cobon(irtdutlmgany accompanying schetlule)andlNRM1erdeClare[hatl recognize[M1a[[M1isF > c ,;; <br /> information lam prov tl ng will he rel ed upon by the County of Burnett Wisconsin in determ nmg wbetherto issuea peril I – ––y– <br /> furtheracceptall liability that may be a result of the County of Burnett relying on this information I am providing In this T S <br /> application. Iagree to permit county officials charged with administrating county ordinances or other authorized Person to r <br /> have access to the above tlewr premses at any reasonable time for the purpose of inspeton "' a > <br /> OWNER'S SIGNATURE bib <br /> Z(date) D nu >'z _. <br /> ZONING ADMINISTRATOR _ - _ _ ... <br /> OC <br /> 7 <br /> m <br /> TOWNSHIP PERMITS MAY BE REQUIRED ffii _ <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISS ENEn COUNZONING <br />