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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator M 0 Z <br /> APPLICATION FOR LAND USE PERMITS _3. <br /> r <br /> F o ^ <br /> N JI <br /> c <br /> m <br /> OWNER UTEk 8u i lG ers. Inc• TELEPHONE '7/,5-Y6?'-7704c) a <br /> O <br /> m <br /> MAILINGADDRESS 134p COUNTY ftnAn S O <br /> A. 0 <br /> PROPERTYADDRESS ' )YQtC LA'I,I�r jZOfM <br /> P/1 t EL A, CsoVERn�M r IPT Zi Awo 3E tly ME ''A . T chi <br /> LEGAL DESCRIPTION(see tax receipt) <br /> S�C'rT N 24 -MW /SW i10 4444=c „w <br /> DWELLING/BUILDING & GARAGE/ACCESSORY STRUCTURE ADDITION ❑ <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ p n <br /> STRUCTURE/ADDITION USE: I�ME (��//� QrGCGICi N <br /> o _ <br /> (Home/Cabin; Commercial Busine s' edroom; Deck; etc.) (n <br /> m <br /> BUILDING CONTRACTOR: 1477X— W i/d 0 r.S, /n C • <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n <br /> A y �� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 5 0 q <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C1 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO J 3 <br /> m <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS, ROADS, LAKE, LOT LINES. C <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. I N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o C <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 <br /> NEEDED. Q1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z c <br /> CONDITIONS OF PERMIT: P _� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT `^ ' <br /> ISSUANCE. <br /> C:19 <br /> Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALL ITHIN THE REQUIRED WATER <br /> SETBACK AREA. � � �• n� <br /> 5. S/ <br /> 6 This stt <br /> ructure to be used as private residential X no o a o m <br /> garage/storage only. ,fN_noot tol!b/re'used for human �, 3 a x a <br /> 6Ael+ E � O m C N m O <br /> 7. habitation. S� o N N � 0 <br /> " m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m — �— d O <br /> PP ( 9 Y ) Y Y J G) C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of �_ • �" <br /> all information contained in this application (including any accompanying schedule)and 1 further declare that I recognize m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- D cn <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am w o <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other o m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m <br /> 'n n <br /> M D : <br /> /ZO <br /> � <br /> SIGN HERE v/S, if(. � a <br /> (signature of owner or building contractor) (date) <br /> ZONING ADMINISTRATOR ) m 'w/1/�� 1 W ' ` ` ' '• <br /> �EA b9 fA�N <br /> O N U W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED C <br /> THIS PERMIT SHALL EXPIRE ONE YEAR� F�RQ M DATE,, PIF ISSUANCE <br />