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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator c <br /> APPLICATION FOR LAND USE PERMITS = <br /> OWNER bTELEPHONE. T�0 4S ' 190ct s`l rq 11,.y /h- ,per',-r / -67a <br /> MAILING ADDRESS 1= F <br /> Sao 9 C0,C,1 /o' _43Z.0 . A/06 /7, ssYi7 <br /> PROPERTY ADDRESS =1 ) <br /> 463 '7'] ZnA.,, /') l R<1, Sf,00U/, 5Yy01 <br /> LEGAL DESCRIPTION 39 .✓ <br /> TYPE of PERMIT(S): SINGLE-FAMILY OWEWNq Sr ADDITION 0 DECK 0 GARAGEIACCESSORY STRUCTURE 0 c <br /> -r- ." „1' <br /> BUNKHOUSE 0 59.692(lV)GAZEBO❑ STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE❑ <br /> L z <br /> STRUCTURE/ADDITION USE: N'7" / C4lJ.n I -. <br /> (Home/Cabin; Commercial Business; Bedroom;Deck; etc.) G <br /> BUILDING CONTRACTOR: /03 15 ) -'2 3 <br /> A PLOT PUN MUST BE PROVIDED ON AN 8'/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS .�., C- 'z <br /> WILL BE RETURNED. <br /> M <br /> DIRECTIONS FOR PLOT PUN DRAWING: (AREAL OR TOP VIEW) 7f Y_ <br /> I. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 1 _ <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES FEB)AND ALL NEW <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, v Jam\ <br /> AND INDICATE NORTH (N). c 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 MEASUREMENTS)TO THE ORDINARY HIGH WATER MARK <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 G <br /> TO BUILDINGS, ROADS,LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. y <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE s <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. - ��--/�"• ,1 ) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICAT10 MY BE DONE WHEN 1 ~ <br /> NEEDED. = ' <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. rr <br /> rr z <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. -� J <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. P <br /> 6. <br /> 7. p > gr• r, n o <br /> p n 83' 3"El _ <br /> 3 <br /> knowledge <br /> that this application it is ion(induect and cng any omplete. <br /> I ac nowledschedule)hastbeen exaresponsible <br /> espon eA by me a d bedata Ned accuracy <br /> of a y 3 a U <br /> inommatio co belief i in thise,CorrettanJ couding a. yaccompa yin Nat]schedule) <br /> Ifu further <br /> scare that <br /> tIreccuraq shall , —] <br /> information I am <br /> dig application(includinganyaccompanying Wisconsin <br /> isc nsi in IfurtM1erng whether <br /> Nato issues ethat this <br /> 1 <br /> further ac n l am provlt at may <br /> be atl upon of the County f urnetturned Wisng on t i information <br /> wam pr to issue permit 1 <br /> further ion. I gee Wliabilityrmit may be s ci is or rg d with administrating f BurnoB rel _ 1 — L <br /> ying on Miz information Ism providing in Niz <br /> application. otheeNpermicri oMiser tany re sonleierh purpose inancesor P[M1er authorized person to <br /> have access to the above-deuriheE 9remisez at any reasonable time for the purpose of inspeRion. _ In <br /> a <br /> OWNER'S SIGNATURE <br /> (date) <br /> 20NING ADMINISTRATOR <br /> rs <br /> 2 2M3 =m F = <br /> TOWNSHIP PERMITS MAY BE REQUIRED = - <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUAEI(MNETT COON <br /> ZONING _ <br />