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z <br /> Burnett County 7410 County Road w No. 102, Siren,WI 54972 Office of Zoning Administrator <br /> (� APPLICATION FOR LAND USE PERMITS '1 - - <br /> OWNER P I 1 1 Iu^ I T V SC TELEPHONE I �- -/4v_ 3 <br /> MAILING ADDRESS <br /> y <br /> ��'1-tC �l .l '1'�JG.. -1�. C� . IJ:U Jk (Yrs L:.EI ✓'I.'1 S S�YYy --��yy <br /> PROPERTY ADDRESS ^ ^ ) <br /> V <br /> hzda./. <br /> S <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMITS): SINGLE-FAMILY DWELLING 0 ADDITION 0 DECK(R. GARAGE/ACCESSORY STRUCTURE 0 <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 In <br /> //�� <br /> Z I <br /> STRUCTURE/ADDIITON USE:. if) L IL j v <br /> 1 jJ (Home/Cabin;Commeroal Busness; Bedroom;Deck;etc.) W'L <br /> BUILDING CONTRACTOR: ry 'Q ^ <br /> A PLOT PUN MUST BE PROVIDED ON AN B'A X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PUNS -C�, <br /> WILL BE RETURNED. "' n <br /> DIRECTIONS FOR PLOT PUN DRAWING: ( TOP VIEW) <br /> I. ALL REQUIRED DIMENSIONS at DISTAUCAS NCE$TOO BE SHOWN OR DRAWN TO SCALE. r - <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW a `' <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, v p <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(5)TO ALL LOT LINES,(B)BUILDING(S) �j '-R P <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK SJ C7 <br /> (OHWM)OF TIKE,STREAM OR RIVER AND WETUND AREAS,AND(D)LOT DIMENSIONS. ' <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES ,R, 1 <br /> TO BUILDINGS, ROADS,LAKE,LOT LINES. I <br /> 5. INDICATE IF A WALKOUT BASEMENT 15 PLANNED AND SHOW AREAS TO BE GRADED OR FILLED, <br /> 6. IF SEPARATE PUNS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE <br /> PUNS MUST BE SIGNED AND DATED BY THE OWNER. SLI ) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN v <br /> NEEDED. <br /> THIS PERMIT IS SUB4CI TO ALL CONDITIONS LISTED BELOW: <br /> L DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. = <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. F <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 /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/SrORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 2 ,y > onnnn > oc <br /> --� 25n2 � 5 'ow3 <br /> IJcdanHart mtbeappit is Ma ,moreinanM+omete. I m*nowGub)has been evmisiben ef r arab Maornadac of my 3 ? J _.'luenvind <br /> nfmoaoeaMasBe1Rkerva,micaiaM mon uding . IaccmMMpa MMIam hl )and I curt for scoften <br /> re thtIeconq o1all <br /> Informetlon corrosions!mpommnthis <br /> illWreedupoubithen ucmmf Surnpachedonsin in <br /> etimmirEeclarethetlrempnitt MM NN <br /> former accept <br /> I am proakiny aril)tw be <br /> upon by Ma Coumy o1 Bumelt Wisconsin In information <br /> whether r L9rM a permit I <br /> NrMer ion. I all ee to <br /> rmit may 4 a rvun of the County of Bmrwn n,count Mn inromvtbo r am ithan iq in MTF <br /> apMiation. lapree to permi[muMyomtlaN tllargea wRh aGministreerp county ordinances or oMerauMorizeB person to ne gr <br /> have a¢ess M Me abora4esvitwE p a r�naEM Gme br Me purpoze o/Inspection. <br /> / / y <br /> OWNER'S SIGNATURE J U o <br /> ZONING ADMINISTRATOR <br /> dkl 162013 Bim ' <br /> TOWNSHIP PERMITS MAY BE REQUIRED q `c m <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUA&RNETT <br /> COUNIFAw <br /> ZONING <br /> u. "sones <br />