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Bumett County 7410 County Road K,NO. 102, Siren,WI 54872 ORce of Zoning Administrator r <br /> APPLICATION FOR LAND USE PERMITS <br /> a, <br /> OWNERTELEPHONE <br /> TAw165 1' gi,Q952 - 270 - (n0 <br /> PROPERTY ADDRESS <br /> l/03/ cU�?q ✓l1CJV pA�ofy6l� U) 548o1 s <br /> � y <br /> LEGAL DESCRIPTION <br /> MAILING ADDRESS 1t7-/ II I/ /I IC:JL_j�i Lo., r J� I � <br /> Am ' �P//� If*l�fiPl 1��� `tYiy a <br /> r - <br /> TYPE OF PERMIT(S): <br /> ❑ Single Family Dwelling ❑ Garage/Accessory Structure oirslm ❑ Commercial Building <br /> ❑ °Jnclition ❑ Bunkhouse ❑ Filling/Grading ❑ Commercial Addition .� <br /> 6TDeck ❑ 59.692(ly)Gazebo ❑ Camping Unit ❑Commercial Ace.Structure <br /> STRUCTUWADDITION USE: S-YA:?S d. nhrik z <br /> (Home/Cabin;Commercial Business Bedroom; Deck;eta) G <br /> -BuaolNG mrrTRAcroR:-- <br /> - r' — <br /> n <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. e 4 a <br /> 0 <br /> *** EOUIRED PLOT PLAN INFORMATION--* IIS, t <br /> h"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: g Qy <br /> DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD <br /> Dimensions& Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED <br /> ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc) 4CENTERLINE IF NOT SURVEYED <br /> ;Dimensions&Heights ❑ ALL PROPERTY LINES <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK S. <br /> ❑ ALL WETIAND AREAS <br /> NOTE: Building/structure loobon must be staked for ante verification when deeded. D rl�(j� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y <br /> • Removal or cutting ci trees and g walls,et is restricted dl0ng shoreline <br /> • No structures(including retaining walls,etc.)are allowetl unless specifically perm; ��i 6 2014 a <br /> • No filling,grading,or shore land alteratlors are allowed onless spedfiolN penmitt d <br /> • Driveway most meet width requirements within 50 days of permit• o <br /> �NOP40t to <br /> ybe used forgarage human habit�ati011r for <br /> lag+denoal storage onN BU <br /> --Not COUNTY z <br /> 20NIN <br /> I d«bre Ma[this application o(including any aommw Chant a.responsible, <br /> e le)has been examined by i and m of best information an co t ai a ane - <br /> tyls a It's tmG correctl" ny aoxa . I acknowledge trot I am rmat d claret Me detail mi a¢ut thiol all mandompomMarial In <br /> Mk d plam by is,county any Gomm Wisconsin <br /> n in <br /> and[NMwr ,to is is r r«npnce that this A all atbn y thartem will be <br /> nNiN upon by Me CmrM1y o/Burnett Wism�n in determining rMetber m issue•permit I NrMer ampt all NbRity MM mal tie e <br /> resuh or in County fo my on relying on this r coin orme I am ons tobar in Mhns to atlon. [agree M permit mumyt any is W epee S <br /> with for the pur,asp county ordinances or other auMOHxed wmm�s to Mve access M Me abo*e4ewlbM premises at any reasonable <br /> thine for Me purpose o1 inspection. <br /> n � > nn� �oi <br /> --ADDITIONAL CONDITIONS--- r%A L <br /> QTNlf mapwrT 2S FUR 7N DfGKS A6t£GT 3W THE W-4r, hNy DECKf a m >9 <br /> BUZGT t�FTEA 7NE y STYE Ut5ST WTu, kEQUZRE < ' <br /> /fDOSfyaNi}L Pe�zMzrs. _ Vis : -a' fin <br /> n 8i 81. X <br /> S <br /> 3�c58 ^L' c $ 8 �7 <br /> OWNER'S SIGNATURE ,Q �. <br /> Vale) i R � =. m <br /> ZONING OFFICUL1D ZO/ d a a N <br /> --TOWN/UDC PER S MAY B i REQUIRED "THIS PERMIT ing oa EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> You are responsible for so sated w with state and n be laws ronceming ronstre to c near or y r wetlands, takes, and streams. <br /> Wetlands that are not violates <br /> Me with open water ons difficultis to identify.failure to comply may result in removal or l Resources <br /> of construction that violates the law or other penalties or casts. For moo is sere e o visit Me Dewrtment of Natural Resources U u 8 o c q <br /> wetlands idenofi000n web page or contact a Department of Natural Resources service center. � <br />