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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS N. - <br /> OWNER SLJNpr� TELEPHONE '63_S� <br /> MAILING ADDRESS <br /> SH1/ G,4�'E 1117,W44- 614)Vi- <br /> PROPERTY ADDRESS ��7 �pN£ �-f�� `� .e f ��N/�U,/� W1. �T�j n <br /> 0 <br /> LEGAL DESCRIPTION ( p i S < <br /> 97-ion 1}oNiyfn, f Addd v, ✓b1*QVl - <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE,` <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING ❑ C��O,M,,MEERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o_ <br /> STRUCTURE/ADDITION USE: l>7n�7lG 4-- -I-� o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) ICp <br /> BUILDING CONTRACTOR: vI F,W W 6 Nt F—S n <br /> O 3 <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o <br /> WILL BE RETURNED. <br /> r9 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) p <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. N K n <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, V c <br /> AND INDICATE NORTH (N). CSN o <br /> 3 TO SHOW T CENTERLINE ODIMENSIONS ROAD, C) BUILDI G M MEASUREMENT(S) THE TO ILINES,LL LOT ) <br /> ORDINARY HIGH MARK NG(S) <br /> CEN <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. AJ p <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. w <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 (f) o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. o hJ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST 8E STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 111) ..I <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r- � <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. O Bn <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 <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE SED F R HUMAN HABITATION. <br /> 6. �jiS fM� IV., DM 61+e. /0 3 qq+48 4,.5 OA"— Idl - 7:if ' <br /> 7. i—,qr- kz e_ '/�d(.YPO.LS �P/t'n/CNt �I �G"-L D o 3 3 N <br /> x <br /> 2 " 565055 <br /> 7d <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my 3 0 R ? w <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detall and accuracy of all of'm i5 c �3 <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that thisv a D > to <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in detem ming whether to Issue a permit. I .pe P ?oo < <br /> further accept all liability that may be a result of the County of Burnett relying an this information I am providing In this v o `_^N =o -0 <br /> access tlo the above-described premises t any reasonable time for thepurpose of Inspection.administrating <br /> ior other authorized person to have o iz)to f1 <br /> m S D <br /> > � 0000 <br /> OWNER'S SIGNATURO <br /> � Fn Fsc y <br /> ZONING ADMINISTRATOR ) y �H . RA S n M <br /> nRIM <br /> TCZNSHIP PERMITS MAY BE REQUIRED JUL 12 2012 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE SUANCE " <br /> S0000 <br /> BURNETT COUNTY <br /> ZONING <br />