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ro Z <br /> Burnett County 7410 County Road K,No. 102, Siren,WI SM72 Office of Zoning Administrator a ° <br /> APPLICATION FOR LAND USE PERMITS <br /> ° <br /> a <br /> OWNER Daniel and Linda Hahn TELEPHONE 763-404-1508 <br /> m <br /> p <br /> MAILING ADDRESS 4580 Ranier Ct N Plymouth MN 55446 <br /> PROPERTY ADDRESS 29170 Jana Rd Danbury WI 54830 <br /> LEGAL DESCRIPTION cad in gov lot 6 desc#370596 r <br /> TYPE Or PERMIT(S); SINGLE-FAMILY DWELLING ❑ ADDITION x DECK❑ GARAGE/ACCESSORY STRUCTURE❑ o <br /> BUNKHOUSE❑ 59.692(1V)GAZE130❑ STAIRS❑ FILLTNG/GRADING ❑ CAMPING UNIT III �. <br /> COMMERCIAL BUILDING D COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE❑ <br /> v <br /> STRUCTURE/ADDITION USE: Convert garage to bunk house and add breezeway S <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) 'z <br /> 0 <br /> BUILDING CONTRACTOR: Northland Builders Inc <br /> n <br /> U <br /> A PLOT PUN MUST BE PROVIDED ON AN 81/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O <br /> 3 <br /> WILL BE RETURNED. 77 c <br /> O — — <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) n <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 C <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH(N). C> o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) v z <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK o ? <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. 5' <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES I °0 <br /> TO BUILDINGS,ROADS, LAKE,LOT LINES. G <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 .� <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. - c <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. fir) y <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: <br /> O <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 'z <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 USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. � '� ao 0 o nac `d <br /> Zo .3e 3 9 Cil <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge g o $ w <br /> and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information <br /> contained in this application(including any accompanying schedule)and I further declare that I recognize that this information I > > <br /> am providing will be relied upon by the County o/Burnett Wisconsin In determining whether to Issue a permit I further accept all '° 7 ' b <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 <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- ^ � o o o <br /> described premises at any reasonable time purpose of inspectjon. B yI; o in v, <br /> 6 O U pN O <br /> .� 2f DO00 . 0 y <br /> OWNER'S SIGNATURE ' '� °' <br /> nrn9 :?mc)dv,_n0 <br /> > 1Ing = z <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP P MITS MAY BE REQUIRED SEP 4 2012 - <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF N a U <br /> TT COUNTY g <br /> ZONING <br />