Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N 661 -4z46-4gli S <br /> OWNER � TELEPHONE <br /> MAILING ADDRESS V <br /> �7�5 mo,wo CY C�cHH2VIL1�� lnlnl SS03°o <br /> PROPERTY ADDRESS <br /> �o( ca ko <br /> LEGAL DESCRIPTION IAY Z SI,P�D IU ISo.-t . ZI V9 Z$ S < 17: <br /> GOUT W( 3 Sz. Z3 f 4o ' i215y� TOw� 4NMSO- <br /> S IR NGLEFAMILY DWELLING GARAGE/ACCESSORY STRUCTURE ADDITION ❑ STAIRS ❑ o <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING w❑ CAMPING UNIT❑ BUNKHOUSE ❑ 59.692(1V)GiA1ZEBO ❑ DECK ❑ f a fid` <br /> STRUCTURE/ADDITION USE: GA4A(-.C—: TJ01'6 01-.3 Il0 \S�(I(JL rtpV S� W z <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;; eettc.)�J..�G� .°r. ° <br /> UILDING CONTRACTOR: bM YA AC A - C'410;-11JU-r <br /> ll0-� ot3 bilk A7 O�vtiv-C�( <br /> A PLOT PIAN MUST BE PROVIDED ON AN 8 1/2X11 SHEET F PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS .n vni <br /> WILL BE RETURNED. O� < <br /> DIRECT10N5 FOR PLOT PLAN DRAWING (ARIAL OR TOP VIEW) <br /> S <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. rn C7 5 <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,AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) c <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK r B <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. N i <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES c <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. B 3 <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. �. o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE _ y, <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 /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G O Ai <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ' a C� lry <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. w <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. B <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER o <br /> SETBACK AREA. I `f) <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. F <br /> 6. <br /> 7. 9 owy ow i3 <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge R <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detall and accuracy of all Information 1° o <br /> contained In this application(including any accompanying schedule)and I further declare that I recognize that this Information 1 0 <br /> am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I further accept all c `^N <br /> liability that may be a result of the County of Burnett relying on this information I am providing In this application. I agree to — C�n 8 r' <br /> permit county officials charged dministratlng county ordinances or oth r uthorized person to have access to the above- o m rj <br /> described premises at any reas able a for th urpose of Ins a Ion. m m T m. a <br /> OWNER'S SIGNATURE v Z7i D g S d <br /> T Cr (date) y, _> a <br /> ZONING ADMINISTRATOR V`m 1 E o <br /> TOWNSHIP PERMITS MAY BE REQUIRED L w o W N <br /> TNS PERMIT SHALL EXPIRE ONE.YEM FROM DATE OF ISSUANCE o <br /> mi( d- le'14er mat /M -- 6aJ03 C'&j&44 <br />