Laserfiche WebLink
Burnett County 7410 County Road K, Na. 102, Siren, WI 54872 Office of Zoning Administrator - 3 <br /> APPLICATION FOR LAND USE PERMITS <br /> _ 1 <br /> OWNER � P / / TELEPHONE —` <br /> c <br /> ,/ <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS <br /> x'777 6 rXo;q ron <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE <br /> BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 _ 3 <br /> STRUCTURE/ADDITION USE: PSG p✓Y��i/5 - 1GIC�L .Pw.r4 �cr i..a..r- !/F� ? <br /> (Home/Call CCommerci usiness: Bedroom; D ck; etc.)' <br /> BUILDING CONTRACTOR: &'AlaYC „ - r <br /> A PLOT PIAN MUST BE PROVIDED ON AN 8 yz%11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARLAL OR TOP VIEW) ni <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, O 1 <br /> AND INDICATE NORTH (N). <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 Sj j o 1 <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. (� S <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND GRAINFIELD (DF), AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> S INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 <br /> 6. 1F SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC,THE <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 --C <br /> NEEDED. J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Cy <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE SIU <br /> 3. NO GRADING ES SH INCLUDING <br /> ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY REQUIRED <br /> WATER 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA f` <br /> 5. ACCESSORY STRUCTURE/GARAGEPERMITS'ALLOW FOR PRIVATE'RESIDENTIALGARAGE/STORAGE ONLY.- O -- <br /> NOT TO BE USED FOR HUMAN HABITATION, j, S <br /> 6. W <br /> 7. - A > � ^> oc <br /> A R � r s rrl <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to Me best of my - o j <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of all - - <br /> mfornlatlon contained in Nis application(i ding any accompanying schedule)and I further declare that I recognize that this > <br /> I em <br /> y <br /> Infovnation I am providing be rel ed up n by the county of Bumett Wisconsin n deterrnlning whether to issue a Reit 1 - <br /> further accept ail fab ty tho may be a re calf of the County of Burnett relying on this Information I am providing <br /> in this <br /> application. I agree to permit on lals charged with admi? Ong county ordinances or other authorizeal Person to have - 6 3 ~ - <br /> access to the above-described pre ise [any rensonaof time rthe purpose of Inspection. <br /> o u4 <br /> OWNER'S SIGNATURE y "?x 2eW - <br /> i (date) I— <br /> ZONING ADMINISTRATOR �- D �f1(/�Ip,l IyU <br /> / EE <br /> TOWNSHIP PERMITS MAY BE REQUIRED MAR 28 2()� <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUA - <br /> /l/dTr'- Fy/s/Yn , 9nlc BURNETT_ <br /> ZONING <br />