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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator N ) j C <br /> APPLICATION FOR LAND USE PERMITS ° <br /> � £ a <br /> OWNER TELEPHONE <br /> i.PBPRet Db:Ntal 62ogF l-1 t_ 4,30 -241-SZrr� <br /> r <br /> PRI DESIRTY ADDR1 s <br /> 3033\ L�+"'� C-OKI_ kAr 54 p o <br /> LEGAL DE6CRIPflONt .8 i - <br /> � ( 3yOF r IIz S,rJ N� <br /> MAILING ADDRESS - <br /> :�331 crv�trTM! Roan 4! ) 'pats3v2y v_L� 54830 _ <br /> TYPE OF PERMIT(S): <br /> ❑ Single Family Dwelling CI Garage/Accessory Structure ❑ Stairs ❑Commercial Building _ <br /> ❑ Addition ❑ Bunkhouse E) Filling/Grading ❑Commercial Addition <br /> '✓d-DecqPoaT_l+ ❑ 59.692(ly)Gazebo ❑ Camping Unit 17 Commercial Acc Structure <br /> STRUCTURE/ADDITION USE: Q'.emv, in c�pc.- /� <br /> - P---rcR—li-o'rc-,1 p )ot—L S z <br /> (Home/Cabin;Commercial Business; Bedroom; Deck; etc.) <br /> A <br /> BUILDING CONTRACTOR:_ C.�OT\E,2- 171,11150 LT'(aM'i C t] <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. m 3 <br /> c � _ <br /> ***REQUIRED PLOT PLAN INFORMATION*** <br /> tO—8'h"X It-SHEET OF PAPER DISTANCE(IN FEET)TO: n <br /> �I. DRAWN TO SCALE OR DISTANCES LABELED !R WELL <br /> dQ PROPOSED BUILDING/STRUCTURE LOCATION Q SEPTIC TANK&DRAINFIELD <br /> bl <br /> R>Dimensions& Heights 'W ROAD RIGHT-OF-WAY IF SURVEYED <br /> l EXISTING BUILDINGS/STRUCTURES(Includes deck, porch, etc.) F+CENTERLINE IF NOT SURVEYED <br /> tb Dimensions& Heights Vi, ALL PROPERTY LINES o ,� <br /> NORTH ARROW Zt ORDINARY HIGH WATER MARK . I' <br /> EL--ALL-WETEANO-AREAS, y <br /> NOTE: Building/structure location must be staked for onsite verification when needed. <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: <br /> •✓ Removal or cutting of trees and vegetation is restricted along shoreline <br /> ✓ No structures(including retaining walls,etc.)are allowed unless specifically permitted L� <br /> No filling,trading,or More land alterations are allowed unless specifically permitted L: <br /> Driveway must meet width requirements within 60 days of permit d <br /> Accessory structure/garage permits allow for private residential storage only z h <br /> Not to be used for human habitation or rental storage" n INS <br /> I declare that this application(including an accompanyingschedule has been examined b m and to n beer f m knowledge and' <br /> PP ( 9 Y ) y e tell o y i 1 ' �Q <br /> belief it is We,correct and any <br /> complete. <br /> com 1 acknowledge that I am responsible for Me detail and accuraq of all information <br /> mation ro contained in <br /> this application(IntlWirg any accompanying schedule)and I NHM10 declare net I recognize that this information provided will be <br /> relied upas by the County ne eumen Wisconsin in determining whether in issue a Permit I hither accept all unt,officials Mat may be a <br /> resuwith adf theini County of cou ty on rionc g o r other amwnon]a r movitlinave Nie as to th a I agree M permitcountytnyre coargiod <br /> mbed f <br /> with administrating of inty o tion. z or other auNorizM permits m have access N Me aboveSescribM premises at any reasonable <br /> time for Ne purpose of inspection. <br /> I��,u. (�ter-+�l 5.�ISI G\\�\ IC//7LI��ru, n q > n n n d a - <br /> O <br /> p-- '? ti, <br /> - t = = <br /> -ADDITIONAL CONDITIONS-- <br /> -NEW Ell D[Zic 7DEllNu u-dSER Tri f1j4HuNY 71444 EX/kTNq ' U a e <br /> DELK ' aav <br /> >a IN60a,06 vcW-"vPftj Y' JUN 2 7 2014 d c v s <br /> T c <br /> -/h[F5T NoT EXcGG,t, Sa:EdirEX/STN(n 6WcDuKi fry. `a > 8 i o z <br /> BURNETT COUNTY w <br /> ZONING <br /> OWNER'S SIGNATURE c (�_? I c? N -• <br /> cno -: R <br /> (dace)ZONING OFFICIAL LGLt/-H / In-Z7 1,V - 'a - U <br /> (date) = m <br /> c da <br /> **TOWN/UDC PERMITS MAYBE REQUIRED •'THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE a -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 can be dimwit to identify. Failure to comply may result in removal or modification <br /> of construction that violates the law or other penalties or cosh. For more information visit the Department of Natural Resources m - y g <br /> wetlands identification web page or contact a Department of Natural Resources service center. 0 8 0 <br />