Laserfiche WebLink
z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator 3 <br /> APPLICATION FOR LAND USE PERMITS n <br /> OWNER TELEPHONE - C a <br /> o C, <br /> MAILING ADDRESS �. <br /> _2 6 G <br /> PROPERTY ADDRESS <br /> . <br /> LEGAL DESCRIPTION o <br /> TYPE OF PERMrf(S): SINGLE-FAMILY DWELLING 0 ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE w <br /> BUNKHOUSE ❑ 59.692(SV)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ r' � <br /> 0 <br /> STRUCTURE/ADDITION USE: c. ,2q c, -p f. Z <br /> 0 <br /> (Home/Cabin; Commerc al Business; Bedroom; Deck; etc.) <br /> C\ <br /> BUILDING CONTRACTOR: -� r ^ Lti 2c-Jt-✓L � <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o W <br /> WILL BE RETURNED. '^ <br /> n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) d <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 NEW t� 0 3 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, B <br /> AND INDICATE NORTH (N). N '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 a �I), <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. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> n <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> C <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n .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. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER I \ <br /> SETBACK AREA. L(�� <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. 01 <br /> NOT TO BE USED FOR HUMAN HABITATION. :E <br /> 6. <br /> 7. o 0g 0 o nn0 -0 <br /> tm <br /> zo � nSs ; <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 0 � B gknowledge = 3 �? w <br /> nd belief It Is true,connect and come . <br /> I am <br /> fr the detail an <br /> hat <br /> Information contained in this application(nc uding anyIaccompany ngacknowledgetschedu e)ra esponsible d I further declare that Irecognize that accuracy ofIthls v `E 9a ra N: Y <br /> Information I am providing will be relled upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I C11 ,��, ?w y <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 permit county officials charged with administrating county ordinances or other authorized person to have <br /> access to the above-described premi s at ny reasonable time for the purpose of Inspection. 6 A <br /> H <br /> � > e c c 8 8 <br /> OWNER'S SIGNATURE /�' V �D- <br /> a <br /> L� — C, r] � no <br /> (date) g any a <br /> ZONING ADMINISTRATOR c o s <br /> v - <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> f'C✓m I P/C kt ed Ll <br />