2011/08/18 - LAND USE - LUP - Other

Home Browse Search

^c z Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a 3 P APPLICATION FOR LAND II USE PERMITS q u1 OWNER \\ S \ C'r' �-g._t OCA, J�Iu I+-� y�-Q/'� �Sl.�.;�7 LIU� �� TELEPHONE MAILINGADDRESS a3 �JZQU r \�d. 1.>�UU�"'+` '"t l TU^ I I" 771� PROPERTY ADDRESS a1 (p LEGAL DESCRIPTION vuJ IUT - S°-ct�u.� �� -To....1•'�s1,. p N� rsU 2�rSc IS `� I�..J'nyTY TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION� DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ N BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ COMMERCIAL BUILDING ❑ COMMERCIAL`ADDITION ❑ COMMERCIALA 1ACCESSORY STRUCT�U�REl❑ STRUCTURE/ADDITION USE: C0. n ' iC`tC-Yea..�-�Yv. YUUM"'/y� GY1D/1GL�(JeLI VGY�32� z 0 (Home/Cabin; mmercial Business; Bedroom; Deck; etc.) S `o BUILDING CONTRACTOR: O � A PLOT PLAN MUST BE PROVIDED ON AN 8 'k X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o _ WILL BE RETURNED. � 6 DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m p 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. ,o 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW w BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, J � � AND INDICATE NORTH (N). 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) a TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK D (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. y,/ C7 W QJ 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES q TO BUILDINGS, ROADS, LAKE, LOT LINES. 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE '?1 ?t' i PLANS MUST BE SIGNED AND DATED BY THE OWNER. 91 7O J J NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN co NEEDED. o r THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: p r C' Q 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 9J r, Z 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. d 'A 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER 01 h SETBACK AREA. 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. C NOT TO BE USED FOR HUMAN HABITATION. 6. 7. y o 0 o N n 6 p I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information contained In this application(Including any accompanying schedule)and I further declare that 1 recognize that this c > > m Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I a w < �+ 7 further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have access to the above-described premises at any reasonable time for the purpose of Inspection. y � 3 m > > o ^1 OWNER'S SIGNATURE `.� �"� °� 20(� n > (d te) - � ZONING ADMINISTRATOR (�.'^ a F a M TOWNSHIP PERMITS MAY BE REQUIRED o THIS PERMIT SHALL EXPIRE ONE YEA FRO DATE OF ISSUANCE q U � S0000 3l� Otis`f 0 rsls�