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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> `1 <br /> OWNER <br /> 9 r lel SaS'_'. II- O <br /> MAILING ADDRESS ` <br /> PROPERTY ADDRESS f � <br /> Snl�.Yln <br /> LEGAL DESCRIPTION PC-[ Rmt,):': , .. <br /> TYPE Or PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION 0 DEO(O GARAGE/ACCESSORYSTRUCIDR <br /> BUNKHOUSE 0 59.692(IV)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 ? \ ' <br /> 3 <br /> COMMERCIAL BUILDING❑ COMMERCIAL ADDITION❑ COMMERCIAL ACCESSORY STRUCTURE <br /> J <br /> STRUCTURE/ADDITION USE: •.rQ l7 ` ,xA <br /> _ (Home/Cabin;CommertlzlBusiness; Bedroom; D , etc.) <br />--BUILDING CONTRACTOR <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'/a X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS _ c <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) - CJ <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). 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 MEASUREMENT(S)TO THE ORDINARY HIGH WATERMARK -- - - <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETUND AREAS,AND(D)LOT DIMENSIONS. _ <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. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PUNNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PUNS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE ^ 1 a <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G <br /> L 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. _ <br /> `— 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC,ALLOWED WITHIN THE REQUIRED WATER r <br /> SETBACK AREA. T <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. ., z ',i, nr,nn : - <br /> I declare that this a application r e - <br /> pp ,corretandcmplete. Iackowlede)hat been responsible <br /> the detail <br /> and ac of OjR <br /> knowletlge and belief i I.this ap,li.Rh(meheling a raccompa yin Mate schedule)and I Further scare that <br /> t Irecourary thof at <br /> - _ - o - <br /> informationI n, pnetlinthisill be ration openor the <br /> County <br /> of BurnettWheonsi in determining <br /> wheMato recognize Mat I <br /> information am pabilit that <br /> be e a resultpot by Me Cpu ty of ur Burnett Wrelying o this information <br /> n omia ing wam provier toding <br /> ing In permit i _further ion. I all agree <br /> to <br /> that may be a vials or r, County Burnett county <br /> unt this inahoes r other authorized <br /> p this _ g <br /> application. Iagrec to permi[tounry officials ayreasiMadministratingeithe punryse of <br /> other au[M1orize0 person[o > o <br /> have access to the above-destribetl premises tan reasanabletimef -the E <br /> y purpose of inipeNo _ - Y <br /> OWNER'S SIGNATURE <br /> 1 <br /> n <br /> ZONING ADMINISTRATOR <br /> c <br /> TOWNSHIP PERMITS MAY BE REQUIRED B <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUATiLp ' COUNTY <br /> NTNG <br />