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� z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator _ <br /> APPLICATION FOR LAND USE PERMITS = n <br /> �OWNER TELEPHONE - <br /> p 60/ <br /> MAILING ADDRESS 60 Z-4 e0c, <br /> PROPERTY ADDRESS /J A� £'r i</Yin�. R Jy a.i%S L.c r l✓r syeYc ? SCJ <br /> LEGAL DESCRIPTION •C SCJ�c / Cc �/ rJ I <br /> TYPE OF PERMMS): SINGLE-FAMILY DWELLING' ADDITION D DECK PZ GARAGE/ACCESSORY STRUCTURE IQ (Q \ <br /> BUNKHOUSE ❑ 59.692(lV)GAZEBO ❑ STAIRS D FILLING/GRADING Cl CAMPING UNIT D Y— ,a <br /> COMMERCIAL BUILDING ❑3,// COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITION USE: /ICJ zF2 /C" 6/h rJ...✓ �f.4"L. C VJI ? i, <br /> (Home/Cabin; Com ercial Business; Bedroom; Deck; e 17) I' <br /> BUILDING CONTRACTOR: _ /y/ 4 G r <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 N X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. 56�y'�I^ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) r T� <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 ✓ <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). J 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 I <br /> (OHWM) <br /> F _AKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) <br /> 4. SHOW THEELOCATION OF THE T <br /> E WELL(W), SEPTIC TANK (T)AND DRAINFIELD(DF), AND ALL DISTANCES Sti 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. w6) <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE \ yD�-U`I <br /> PLANS MUT BE SIGNED AND DATED BY THE OWNER. 00 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. `11y' i�'✓`V1 '1r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: C� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. = z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. x <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. T <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER n r `^ m, <br /> SETBACK AREA. W `U <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. 1V! f <br /> 6. <br /> 7. A ,'�, r, .n C'> o � <br /> g_ <br /> n Y333 F <br /> 1 declare that this application <br /> fru ,correct <br /> Z _ <br /> (Including any accompanying schedule)has been examined by me and to Me Cert o!my 3 e � 3 ,^^, <br /> knowledge and belief It Is true,comeR and romple[en i acknowledge that 1 am responsible for Me detail and accuracy of all <br /> Information I am providing <br /> di this ill he reM1on upon by t any accompanying schedule)and 1 further declare whether <br /> her 1 risen x Mat thisInform <br /> further am 1 am pravlity t wig a relied a upon by Me county of Burnet[Wisconsin In determining minlnq w am r to Issuer pennll. I <br /> further adept all liability that may be a t of the County of nen relying on phis In mi 1 am providing In MIsN <br /> application. 1 agree[o permit county de Uarq�d.w.M a sVdllnq county ordlnan[es or oNer auNodxed person ro have <br /> amen m Me above-Oeudbetl preml5ls a[ ny r 65o ble ire r Me purpose of Inspection. <br /> III111 go 8a _ <br /> OWNERS SIGNATURE j`_'--� - 0 <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUAN(ffURNETT CO <br /> ZONING N <br />