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y a Z <br /> Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS _ <br /> OWNER Carl Baht TELEPHONE <br /> MAILING ADDRESS #1 Snowy OM In Nonh Oaks MN <br /> I <br /> PROPERTY ADDRESS 22862 Leef Rd <br /> n T <br /> LEGAL DESCRIPTION Lot 2 CSM V14 P159 <br /> TYPE OF PERMTrLB): SINGLE-FAMILY DWELLING ❑ ADDITION X DECK O GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE. 59.692(IV)GAZEBO❑ STAIRSO FILLING/GRADING0 CAMPINGUNITO <br /> COMMERCIAL BUILDING O COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE O <br /> STRUCTURE/ADDMON USE:_Brmzeway - 3' <br /> (Home/Cabin;Commercial Business, Bedroom;Deck;etc.) Ilhp-J o <br /> BUILDING CONTRACTOR: Nortfliand Bubblers Inc <br /> rl <br /> A PLOT PUN MUST BE PROVIDED ON AN 8`A X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS c � <br /> WILL BE RETURNED. o <br /> DIRECTIONS FOR PLORED DIMENSIONS <br /> DRAIONS OR DI (A IALCES O TOP VIEW) r <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR <br /> SI DRAWN RE SCALE. ,. <br /> 2. SHOW THE LOCATION AND SIZENC ALL EXISTING WIRCHESSAND OTHERS (EB)AND ALL NEW <br /> BUILDINGS/SIRUCNRES(NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, n <br /> AND INDICATE NORTH(N). d <br /> 3. SHOW DIMENSIONS IN FEET OFTHeE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDING(S) N <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK d o a <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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 <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. N o <br /> / ^ pR'J <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MV BE DONE WHEN t <br /> NEEDED. d�'� <br /> i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. r <br /> G <br /> 2. NO GRADING <br /> OR TING OF SHORELAND ES ANDVEGETATION <br /> RE AL O RESTRICTED ALONG SHORELINE. e <br /> 3. NO GRADING ESSHORUDING RETAINING <br /> W ARE ALLOWED UNLESS SPECIFICALLY REQUIRED <br /> E WA <br /> - — 4. NO STRUCTURES,'INCLUDING RETAINING WALLS,ETC;ALLOWED WITHIN THE REQUIRED WATER ^" z - - <br /> SETBACK AREA. O <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. lfl CIl <br /> NOT TO BE USED FOR HUMAN HABITATION. C� <br /> fi. <br /> ]. qn n333c' o_ p <br /> I deClase that this applicannn(Including any accompanying schedule)has been examined by me and to the best of my knowledge 3 ?2 2 a <br /> and beIIN it Is true,corral and comphe e. I adnowledge that I am responsible for the detail and accurap of all information <br /> mmalne4 In this appliotlpn(bMWilq any accompanying schei and l further disease hat l recognize riot Mit information l <br /> m proNdlrg will be relied upon by the County,of Burnett Wlscopsin In determining whether to issue a permit I father accept all <br /> liability that may be a result afthe County of Burnett relying on this Information l am providing in this application. Iagrelto c .8_'r— �Y' 'e <br /> permit county afflclals charl with administratim county ordinarces or other autbeHsed person to have acomm to the above- <br /> desslbed premixes at a"reasobebM Bme for the purpose of hupectbn. ° w E,w5 n <br /> /j n rt cn88 � <br /> OWNER'S SIGNATURE <br /> (date) <br /> a � <br /> ZONING ADMINISTRATOR w m <br /> a Ac am <br /> TOWNSHIP IZERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE O U 6,213 <br /> ��E 2 <br /> BUR ETT COUNTY <br />