Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator o <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER /� /� TELEPHONE 715 b3q 9977 d U� <br /> MAILING ADDRESS 1 03 1k 11 /� U-,U,U774� / ftW4 ^,� �� Tub. vl p <br /> PROPERTY sYi, Cl 9� •(JNs g W d /7 GIXr�,U (/7 <br /> n <br /> LEGAL DESCRIPTION <br /> SINGLE FAMILY DWELLING ❑ GARAGE/ACCESSORY STRUCTURE V ADDITION ❑ STAIRS ❑ <br /> TYPE OF PERMIT(S): ,a <br /> FILLING/GRA�j NG ❑^CAMPIN�/UNIT ❑ BUNKHOUSE,❑, /59.692(IV)GAZEBO ❑ DECK ❑ <br /> �OI2K S <br /> STRUCTURE/ADDITION USE: l`Jf},' /(.cFFFF{ � �}GE o Q <br /> /Home/C InnCommme�rccial Bu <br /> s <br /> iness <br /> ,' B)dd��dfirggyyy66666m; Deck; etc.) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'F.X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. <br /> o_ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. nnf <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, to w <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) <br /> 0 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 9 <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. N <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES 5. o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. p o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> r^ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN v) <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: v) O <br /> r z Q <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. F <br /> 6. <br /> � aaoro <br /> 7. FM <br /> ff ry F F d <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information a 0 <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Information I "ao <br /> am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I further accept all O; N o w 8 'o <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 officials charged with a Inlstratlng county ordinances or other authorized person to have access to the above- (] <br /> described premises at any reasons me for the pure a of Inspe n. m C) a = y <br /> OWNER'S SIGNATOR <br /> ` (date) iA <br /> ZONING ADMINISTRATOR I I � ( 5 <br /> w! tie, <br /> TOWNSHIP PERMITS MAY BE REQUIRED C71 22 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE �w S <br /> JQ&(Y1 , 4 le4-442r picked up hj 6awt AAe�lr <br />