Laserfiche WebLink
o <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a <br /> APPLICATION FOR LAND USE PERMITS N N <br /> OWNERjb lV � TELEPHONE d <br /> MAILING ADDRESS G1 <br /> 5LIS - v <br /> Rif 7S �h� h�� la�� mol S�r�h � <br /> ( <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION R <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION DECK ❑ GARAGE/ACCESSORY STRUCTURE D <br /> ` <br /> 41 <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ ,�� <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMER/CIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Co/m�merci I Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: 5e <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 '/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O c <br /> WILL BE RETURNED. <br /> f1 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. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW K7 w 3 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). N c <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 ' G <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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF 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 .� Q <br /> NEEDED. <br /> S <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 09 !� I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z Ln O <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <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 <br /> GARAGE/STORAGE ONLY. <br /> NQTTO E OR HU11010 1 -MAN HABITA,jIOfl./ 7d, OA L — AA) ee;O'/L�T`d�_ <br /> a e <br /> 7. <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all m d m R it <br /> Information contained In this appllcatlon (including any accompanying schedule)and I further declare that I recognize that this c_ 9 D m N <br /> Informatlon I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to issue a permit. I 5 2 c 0 b <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing In this <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have <br /> access to the above-descjpmmisesny reaso abletime for the pu se of inspection. oo 0 >OWNER's SIGNATURE > ^' � +date) f�1 a o 9 4oZONING ADMINISTRAa. <br /> NSHIP PER ITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N o <br /> 80000 <br />