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Barnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator g c <br /> APPLICATION FOR LAND USE PERMITS -)F <br /> W a -Z5 - 3177 c <br /> OWNER� �� /�� TELEPHONE <br /> ILJWeA ©r1�1e1� <br /> PROPERTY ADDRESS <br /> atmsr / }T ra% <br /> u1 07 , i <br /> LEGAL DESCRIPRON '7/ <br /> MAILING ADDRESS 5 1� Iv/ v S �. <br /> TYPE OF PERMIT(S): rn <br /> Cl Single Family Dwelling Garage/Accessory Structure ❑ Stairs ❑ Commercial Building a =. <br /> ❑Addition Bunkhouse ❑ Filling/Grading ❑ Commercial Addition •2 <br /> ❑ Deck ❑ 59.692(ly)Gazebo ❑ Camping Unit ❑ Commercial Add.Structure <br /> O 3 <br /> STRUCTURE/ADDITION USE: ti�� <br /> (Home/Cabin;Com erdal Business; Bedroom; Deck; etc.) C <br /> , nn z <br /> BUILDING CONTRACTOR: O <br /> n � = <br /> PLOT PLAN---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. CT 3 z <br /> M _ <br /> °'*REQUIRED PLOT PLAN INFORMATION*** m g <br /> ❑ 8'/z"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: o <br /> ❑ DRAWN TO SCALE OR DISTANCES LABELED Cl WELL <br /> ❑ PROPOSED BUILDING/STRUCFURE LOCATION ❑ SEPTIC TANK& DRAINFIELD <br /> 4Dimensions&Heights ❑ ROAD RIGHT-OF-WAY IF SURVEYED <br /> ❑ EXISTING BUILDINGS/STRUCTURES(Includes deck, porch,etc.) _ 4CENTERLINE IF NOT SURVEYED <br /> 4Dimensions&Heights ❑ ALL PROPERTY LINES <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK ^� <br /> ❑ ALL WETLAND AREAS LLL c <br /> NOTE: Building/stmcture location must be staked for Onsite venfication when needed. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: IN 1 t <br /> • Removal or cutting of gees and vegetation is restrictedalong shoreline <br /> • No structures(inducing n d walls,etc.)are allowed unless specifically pe <br /> • No filling,grai g,oshore land alterations are allowed unless specifically pernitttec <br /> • Driveaay must <br /> ( h <br /> �r <br /> meet acag requirements within 60 days res dof epermit QQ f <br /> • Accessory a used <br /> human <br /> permits allow for private residential storage only (� ? t <br /> Not to be used for human habitation or rental storage" ❑ rm <br /> I declare that this application(including any accompanying schedule)has been examiner)by me and to the best of my knowledge and IyN�n1 <br /> belief it is true,correct and complete. I acknowledge Mat I am responsible lir Me detail and accuracy of all information contained in <br /> this application(including any accompanying schedule)and I further declare that I recognize that this information Provided will be <br /> relied upon by un County a Bumex Wisconsin In determining whether in issue a permit I further accept all liability Oat may charged e a <br /> rewR of Me County co Bumett in a ingnce o rMis r authorize[ er providing in Mis application. I agree in permit c ise sa officials sonable <br /> with foradministratingpurpose <br /> county ordinances or other authorized persons to hav<acttss to Me above-described premises at any reasonable <br /> time lir Ne purpou of inspection. <br /> npp �❑ > rrnr, p65 <br /> ---ADDITIONAL CONDITIONS-- D �'I -��\yV� ^ » a 3 3 <br /> lUf tJ11L��� 'z = ,"3 ,'^, <br /> lo <br /> JUL 2 5 2014 <br /> u,< fnm <br /> BURNETTCOUNTYS <br /> Z-- orad ' <br /> OWNER'S SIGNATURE <br /> (oil <br /> ZONING OFFICIAL <br /> a E c <br /> date) <br /> "TOWN/UDC PERMITS MAYBE REQUIRED "THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE -You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. - <br /> Wetfands that are not associated with open water can be difficult W identify. Failure to comply may result in removal or modifiation of construction that violates the law or other pervades or costs. For more Information visit the Department of Natural Resources - _ = <br /> wetlands idenbfication web page or contact a Department of Natural Resources service center. <br />