Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Admilnistr4tor z <br /> APPLICATION FOR LAND USE PERMITS <br /> z <br /> C/llpsi 303 7� 7 s <br /> OWNER 5v&,t � /` tr fr.uts TELEPHONE 71J5- t75-6 7z o <br /> 77 f�tL/ 7Z 3 aid/�y'�(� feet Sf asc ml?r .S.S// /'�i(6S//Gf-19 7ro66 <br /> MAILING ADDRESSwz O <br /> 0 <br /> PROPERTY ADDRESS C973 <br /> 7-4 h OI" 44,0`40- /J ✓Q r/ D✓�Ld el, <br /> LEGAL DESCRIPTION ( g <br /> SINGLE FAMILY DWELLING ❑ GARAGE/AICCESSORY STRUCTURE III ADDITION ❑ STAIS ❑ <br /> TYPE OF PERMIT(S): 'd <br /> FILLING/GRADING ❑( CAMPING UNIT❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK 11STRUCTURE/ADDITION USE: �/!D WP Te,11T Z <br /> (Home/Cabyi�, Commercial Business; Bedroo , Deck; etc.) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Va X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PI ANS C <br /> WILL BE RETURNED. <br /> tv <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C I <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, m '° <br /> AND INDICATE NORTH (N). (� <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) n <br /> TO CENTERLINEF ROAD', (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK ,e <br /> (OHWM)OF LAKE STREAM OR RIVER AND WETLAND AREAS,AND (D)LOT DIMENSIONS. <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: w <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. f <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., HE a <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> t <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE W ENNEEDED. <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: <br /> z 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ' <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <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 /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. Q <br /> 6. <br /> ^ ,hd >nm a� ,e <br /> 7. <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowle,Jge _ <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information p <br /> contained In this application Incl Win an accompanyingg.. <br /> ( g Y schedule)and I further declare that I recognize that this Informs I & r„ <br /> am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit I further accept all <br /> liability that may be a result of the County of Burnett relying on this information I am providing In this application. I agree to <br /> permit county officals charged with administrating county ordinances or other authorized person to have access to the above- 8 n <br /> described premises at any reasonabliLtIme for the purpose of 1on. w <br /> OWNER'S SIGNATURE /^� e e a 2 <br /> o (date) <br /> ZONING ADMINISTRATOR <br /> < : P <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 8 o <br />