Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator < W <br /> APPLICATION FOR LAND USE PERMITS bT\ <br /> OWNER TEL P NE <br /> ,S�U�-_ t-- <br /> 0 <br /> MAILING ADDRESS/ �� <br /> YCC� /ZO Zr <br /> PROPERTY ADDRESS iJUr'? �/ <br /> LEGAL DESCRIPTION <br /> 4e7- <br /> D,_ r /v //7 -� / W ° <br /> ke- <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE- �. <br /> BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0CAMPING UNIT❑ <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 S <br /> STRUCTURE/ADDITION USE: ,L, r P <br /> (Home/Cabin;CommercialBusiness; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2LA <br /> z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PNS <br /> WILL BE RETURNED. <br /> n o. <br /> m o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) d m <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEWo`, o <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, o N o <br /> AND INDICATE NORTH (N). o z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 9-' 00 0 <br /> (OHWM)OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS. IN O <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES op 5. N <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. h <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ° <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE y <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: F T <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ¢ m Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. O 'A <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. h <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. E <br /> 6. <br /> 2. z > O O O G ro <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of myo ,f°^, A A $ ? <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all El <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this `° E. D E N <br /> information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this s9 N 7 <br /> application. I agree to permit county officials charged with administrating coun ordinances or other authorized person toC] m <br /> have access to the above-desc ' d miles at an so ble ime for purpo of insp 9 w N w r) <br /> c qy '° oo go Y <br /> OWNER'S SIGNATURE "''�"' <br /> C (d <br /> ZONING ADMINISTRATOR n OCT 5 2012 <br /> N � � O Ctrl <br /> TOWNSHIP PERMITS MAY BE REQUIREDV, <br /> q <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF <br /> COUINONTY S <br /> �N <br /> 69 .- NM1A d1 O <br /> Vin O O O O O <br />