Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator _ c <br /> ' I APPLICATION FOR LAND USE PERMITS <br /> OWNER A. // {r. TELEPHOfL ,5�V3 1 FS7 \ <br /> MAILING ADDRESS ' b5 c'\ <br /> Q \"v, . 0 \. N . S1 <br /> PROPERTY ADDRESS 3\ 71 l L.y�.� �� �1, , S y S 3 c <br /> LEGAL DESCRIPTION D'�' G .S U 5 3 3 5F <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWEWNG❑ ADDITION ❑ DECK O GARAGEJACCESSORY STRUCTURE <br /> BUNKHOUSE❑ 59.692(IV)GAZEBO ❑ STAIRS ❑ FIWNG/GRADING O CAMPING UNIT❑ _ v <br /> COMMERCIAL BUILDING ] `COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE G ' <br /> STRUMRE/ADDITION USE: }-F / CS (N-�� " ? <br /> ( me/Cali Co menial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: C1 �-J r x.� <br /> z < <br /> A PLOT PUN MUST BE PROVIDED ON AN 8 V.X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) <br /> L ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. r' <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW Cf r\ g <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, VyV ` —' <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT HNES,R)BUILDING(S) Pi 11 <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK G yWWW <br /> (OHWM)OF LAKE,STRUM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. w. <br /> 9. 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 s <br /> PUNS MUST BE SIGNED AND DATED BY THE OWNER. <br /> t <br /> NOTE: BUILDING/SIRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN n I <br /> NEEDED. <br /> t�I <br /> THIS PERMIT 15 SUBJECT TO ALL CONDITIONS LISTED BELOW: cam: f <br /> L 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. T <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED C <br /> 9. 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. <br /> 6. <br /> 7. <br /> ]Declare that this application(including any acwmpanS <br /> ying schedule) been examined by me and[o[M1e pert of my 3 ? J a . B i <br /> knowledge and belief it is true,corteu and complete. I acknowledge Mat I am responsible for Me derail and accuracy,of all _ - E 5 r y <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that Mis __ ac <br /> information am providing will b,relied upon by Me county of Burnett Wisconsin in determining whether to issue a permit ] — <br /> further accept all liability that county <br /> ty a result of Me county of Burnett relying an fem Information i am providing in this 23 <br /> hale acesstoheetopermit county oRdals charyetl with administrating county oNinancesaraMerauthorized person to <br /> M1ave access to the above-desc bed premisesat any reasonabiltime.pIJ'.Me purposeofms�ctiO,. <br /> OWNER'S SIGNATURE <br /> (date) I <br /> ZONING ADMINISTRATOR ,G/�`"`��` ` �': '� - iF J m_ r <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE _ <br />