Laserfiche WebLink
,T z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a Z <br /> APPLICATION FOR LAND USE PERMITS s <br /> OWNER �n,� ►Anw.... /t,,., �1 IEt t cQ TELEPHONE <br /> MAILING ADDRESS I I�224 t pt?:LLVtZ CT, <br /> t LCL �V 'S631 <br /> A j <br /> PROPERTY ADDRESS EASTM �t - ' ten,\�11 per( lad-r•' 5t S 0 <br /> �--I Y6L�Y\IV Lyy{�i W01.(_� �/�j�,., IL1-/C.Lnl / 1'1 < <br /> LEGAL DESCRIPTION CSM V.,22- t'* � Sys I, S g T'w W <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE ACCESSORY STRUCTURE y <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ <br /> LfCC1OCM�MLIEVRCJIALf1ACCESSORY STRUCTURE 0 <br /> STRUCTURE/ADDITION USE: GAFPGG i , Cp,11, WJC�— > ylwURAGF— <br /> (Home/Cabin; <br /> 'F—(Home/Cabin; <br /> Commercial Business; Bedroom; Deck; etc.) <br /> G� o <br /> BUILDING CONTRACTOR: r) QJS <br /> ti <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS G <br /> WILL BE RETURNED. e } <br /> 6 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) F <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. v °' <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, i <br /> AND INDICATE NORTH (N). N o <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 Q> <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. O O <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. v, <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. SU <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE o i <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. �d a Om <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: d O O <br /> C v O <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. -1) " O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER G A O <br /> SETBACK AREA. < <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NQT TO BE USED HUMAN HABITATION. <br /> 6. I�CJCp�.r.7Lfl�a ms o�tlr�� av} Vartance-*149& <br /> 7. s y a o o c) > 0 7 <br /> 5 EI <br /> rtH n f [=1 <br /> F r' w EiR a o o' S' <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 0,°2 . . n <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> Information contained in this application(including any accompanying schedule)and I further declare that I recognize that this .� c. > > m <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 <br /> application. I agree to permunty officials charged witVadministniting county ordinances or other authorized person to have <br /> access to the above-descri d miles at y re: fi b ti r the a of Inspectigq. °m n sw ti w > <br /> a 6 O O O <br /> .�. <C 6600 000 <br /> OWNER'S SIGNATURE o d, > m m d p . = 2 <br /> (date) d <br /> Sf✓Y� <br /> F1 ( ciao y y a y F t m <br /> ZONING ADMINISTRATOR - N w — o <br /> R � E 16 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> ° 0000 <br /> peVOI 4 k,o Wet le�3aa-� 1 <br />