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to 171 <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator 3 C <br /> APPLICATION FOR LAND USE PERMITS e <br /> OWNEIt,I�a, LLYa(d y/ ^M1X ILEIPH-01NEl b _ 1 - 0 <br /> _sy �II1 yy�wa� �� \ <br /> PROPERTY ADDRL35 <br /> �1Q3� ^ and/ 1—nkF �Rpryli^1 p� <br /> LEGALDESOUPTIDN /„vel . W I � �.A�•• as T l�lsl p , <br /> MAILIN; -fiR155�CLVkL��-e11.1� G- Linn I aKeS MW SSOSS 9€ <br /> TYPE OF P5): -- / <br /> ❑ Singlee Family Dwelling "Garage/Accessory Structure O Stairs LI Commercial Building <br /> 0 Addition I] Bunkhouse 0 Filling/Grading 0 Commercial Addition .� <br /> 0 Deck 0 59.69922.(lv))Gazzebo//��'-tJ Cl Camping Unit 0 Commercial Aa. Structure <br /> STRUCTURE/ADDITION USE: �A*E1 l" a d/]-P — o <br /> (Home/Cabin;CorQgbrial Business;t om; Deck;etc) '^ <br /> BUILDING CONTRACTOR: JCCJ C- TOSSfJt.J - O <br /> w I <br /> ROT PLAN---INCOMPLETE OR ILLEGIBLE PLOT PLANS MaU BE RETURNED. In <br /> a**REOUIRED PLOT PLAN INFORMATION"- <br /> 8%'X <br /> NFORMATION"-8%'X 11'SHEET OF PAPER DISTANCE TN FEETI TO: <br /> t9 DRAWN TO SCALE OR DISTANCES LABELED / WELL l <br /> l7 PROPOSED BUILDING/STRUCTURE LOCATION Cl SEPTIC TANK&DRAINFIELD <br /> / 4Dimensions&Heights Q ROAD RIGHT-OF-WAY IF SURVEYED <br /> ar <br /> O EXISTING BUILDINGS/STRUCTURES(Includes deck,porch, etc.) / CENTERLINE IF NOT SURVEYED <br /> / -)Dimensions&Heights t?I ALL PROPERTY LINES o <br /> I] NORTH ARROW � ORDINARY HIGH WATER MARK �. <br /> tif ALL WETLAND AREAS rn <br /> NOTE: Bliltling/structure location must be staked for onsite verification when needed. <br /> THIS PERMIT 15 SUBJECT TO ALL CONDITIONS LISTED BELOW: RDECEYED• Removal or curing of trees and vegetation is restricted along shoreline• No structures(including retaining walls,etc.)are allowed unless specifically permltt• No filling,grading,or shore land alterations are allowed unless specifically permittedAUG 13 2014 <br /> • Driveway must meet width requirements within 60 days of permit <br /> • Accessory structure/garage permits allow for ovate reselential storage only <br /> **Not to be used for human hatdtation or rental storage— BURNETT RUNTY pO A <br /> R <br /> 1 declare that ,co application(including,I any accompanying acknowledge <br /> at as mresp has been examined by accuracy mM to knowledge d in <br /> belie)it is true,wncludand complete. 1 acknowledge Mat I am responsible for the detail and Metth of all radon pro contained in <br /> this dapplicationobhe County any accompanying n in dale)and 1 further declare that 1 recognize thee this information provided will It <br /> relied upon by Me County of Burnett Wisconsin in ration I am owerin m this a permit 1 hgreer atter[all liability officials Mat may re a <br /> with administrating <br /> Me County co Summit <br /> ordinances <br /> on other <br /> information l am pmvio ha in this to Mea I agree to permit premises <br /> atay easonableged E <br /> with for the purpose <br /> wanly p tion. cez pr brier authprieed persons to have access M Me alwve-described premius a[any reasonable <br /> time for the purpose of inspection. <br /> •at a99 nab <br /> ---ADDITIONAL CONDITIONS--- y 3 3 3 ' $ <br /> a 339ffg <br /> �cylFkAcrF My45r BE R Ms.VswsHh of yo FT FROM TH6 2ai4D a sm^ t 9 <br /> cgAITER�T ✓E V6R VhA-TA-NCE VRA-IY-07. Ne. am <br /> aw <br /> 7h-Rgc F- MD51- /11T M//AI of ..FT fRoM 7hL 50UTN ° S.g <br /> LoT [SAIF PBk V,4 S VTR-/4-07e PEk 6 � > g#' g" 3 <br /> 3 �,gtgcyE AMA � V� �vA"Qf�14-0 J m o� 8808 : <br /> OMER'S SIGNATURE ✓�11 /1 I a� 5 <br /> ta.b. <br /> ZONING OFFICIAL 8 /g / a 5.: B V <br /> t ) sca <br /> *'TOWNpUOC PERMITS MAY with <br /> state and "THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE F; !• <br /> You are responsible are <br /> for caiated g with state and federal laws conceming construction to near or y r wetlands,re lakes, modification streams. <br /> We onstr that are no[associated law open water ran be r costs b itl More Failure do comply may rerun ie removal ur lReou es <br /> of corlsfiKtion that violates Me law or oUler penalties or costs. For more informahon visit the Department of Natural Resources " e o 8 <br /> wetlands identification weo page or contact a Department of Natural Resources service center. <br />