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 <br /> OWNER L /) TELEPHONE ��� �_7rV <br /> MAILING ADDRESS Z ''v 'V /Ci <br /> /V <br /> PROPERTY ADDRESS ' /I <br /> - <br /> 722 2 C �/(.at' y n��=L.A-✓� `T'�„" S/' o i <br /> LEGAL DESCRIPTIC�!�� IIIIJJJJ V VVVV VV '1r- <br /> l.� I <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION 5;' DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> 0 <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ CCOOMMERCIAL ACCESSORY STRUCTURE ❑ o <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: L L �. w <br /> n <br /> O <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o_ <br /> WILL BE RETURNED. r <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m O <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, <br /> AND INDICATE NORTH (N). N z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) 0 0 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. �p <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 /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. _—Q- <br /> 6. <br /> C .. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE G �/ o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. QJ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN Q ) <br /> NEEDED. r <br /> (i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 1 r- — <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. b n z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. B <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. C> <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. 'A a o 0 o m c 7 <br /> 2' No o' <br /> I declare that n <br /> at this application(including any accompanying schedule)has been examined by me and to the best of my � o ,'Z B g ? w' <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for Me detail and accuracy of all n m = iv d.rn <br /> information contained In this application(Including any accompanying schedule)and I further declare that 1 recognize that this E.9 Y a <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I ii w< ' 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 ° m Q <br /> access to the above-described pre <br /> j//guises aayt any/treasonable time for the <br /> f�purpose <br /> 7 of Inspection. >c S o e 8 <br /> OWNER'S SIGNATURE G <br /> n Fn a>:mno �,-n0 <br /> ZONING ADMINISTRATOR J �rn _ = <br /> C wF a C+1 <br /> G <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE " <br /> u e o o F <br />