Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator C <br /> APPLICATION FOR LAND USE PERMITS - <br /> OWNER Lle�Nln{ JTCIe�r'` TELEPHONE 95a / <br /> _ /CO —V/YI 1 o <br /> PROPERTY ADDRESS _SPe, <br /> p ata 13 46 5 L � I� <br /> LEGAL DESCRIPTION 2 e, I n n1 1 //����� '93 t� rvorO�� -R(s r. (J, <br /> MAILING ADDRESS � � / �i I /�S )'i a /-FU Z.. Sw i-NPS'' 1 r��l ulG /I'ry S i 091 <br /> / o <br /> TYPE OF PERMIT(S): <br /> ❑ Single Family Dwelling ❑ Garage/Accessory Structure ❑ Stairs ❑ Commercial Building <br /> ❑ Addition ❑ Bunkhouse ❑ Filling/Grading ❑ Commercial Addition •2 <br /> ❑ Deck ❑ 59.692(ly)Gazebo Camping Unit ❑ Commercial Acc. Structure 3 <br /> STRUCTURE/ADDI TON USE: 02 M {'v5 1 t z <br /> ( e/CabiIn Commercial Business;Bedroom; Deck;etc.) <br /> z <br /> BUILDING CONTRACTOR: /v 'T O <br /> n � <br /> r <br /> PLOT PLAN--- INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> **'REOUIRED PLOT PLAN INFORMATION-" m <br /> ❑ 8'/0"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: o <br /> ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD <br /> 4Dimensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED <br /> ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch, etc.) 4CENTERLINE IF NOT SURVEYED - <br /> ->Dimensions& Heights ❑ ALL PROPERTY LINES c <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK 5. <br /> ❑ ALL WETLAND AREAS -s <br /> NOTE: Building/structure loallon must be staked for onsite verification when needed. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I Imo• <br /> • Removal or cutting of trees and vegetation is restricted along shoreline <br /> • No structures(including retaining walls,etc.)are allowed unless specifically permitted _ <br /> • No filling,grading,or shore land alterations are allowed unless speofially permitted <br /> • Driveway must meet width requirements within 60 days of permit d <br /> • Accessory structure/garage permits allow for private residential storage only <br /> Not to be used for human habitation Or renal storage" <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and <br /> belief it is time,correct and complete. I acknowledge Nat I am responsible for Ne detail and accuracy of all information contained in <br /> this application (Including any accompanying schedule)and I further declare Nat I recognize Nat this information provided will be <br /> relied upon by Ne County ofBurnett Burnett Wisconsin in determiningam whether in issue a cermic t mrteer acmpt all liability Nat maybe a <br /> suit of the County ofmyorordinances <br /> on other authorize I am proons to have access to Me n. I agree rated p Permitcountyatofficialsnreasom ged < <br /> with for Me [ratio county ordinances or other authorized persons[o have access N Ne above-tlezcribed premises a[any reasonable <br /> Mine for Ne purpose Of inspection. <br /> oaa si <br /> ---ADDITIONAL CONDITIONS--- p � � __)/— w 4 n 3 n = 2 <br /> � LtA./�Pth� U/LL I - z a d.a. ;? _ <br /> - ND = - - <br /> t!^ C°� /� t Perms <br /> a > <br /> � <br /> 3 S000Bc - <br /> OWNER'S SIGNATURE ! <br /> ` / OJ / n > Z <br /> ( ate) o Ri <br /> ZONING OFFICUL <br /> (Gate) - <br /> "TOWN/UDC PER S MAY BE REQUIRED "THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE - - <br /> You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. <br /> Wetlands that are not associated with open water an be difficult to identify. Failure t0 comply may result in removal or modification <br /> of construction Nat violates Ne law or other penalties or costs. For more information visit Ne Department of Natural Resources <br /> wetlands identification web page or contact a Deparbnent of Natural Resources service center. w,' <br />