Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administri for c <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER f�J, - 1 TELEPHONE �� I O J <br /> L I e T — 1i <br /> MAILING ADDRESS ^ _ I p c O <br /> 0 <br /> PROPERTY ADDRESS m <br /> 4 U � <br /> n <br /> LEGAL DESCRIPTION <br /> SINGLE FAMILY DWELLING ❑ GARAGEEI/ACCESSORY STRUCTURE ADDITION ❑ STAN ❑ <br /> TYPE OF PERMIT(S): y <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK ❑ <br /> STRUCTURE/ADDITION USE: G- Ckrix <br /> (Home/C bin; Commercia Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: 9 Oyl <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT P NS C 3 <br /> WILL BE RETURNED. <br /> o <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW R <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, t� <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDI G(S) n <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK v <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. N ;n <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTA ICES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. ao <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. o Q> <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., FHE a <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> H i <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE W iEN —_ <br /> NEEDED, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -}— <br /> r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z SOp <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N <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 C NLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. f <br /> 6. <br /> ^ ry� anmoaoro <br /> 7. '0 2 `F°-2x x " � <br /> B 'O �wc F aow <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of myknowledge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information o <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Informatioi i I <br /> am providing will be relied upon b the County of Burnett Wisconsin In determining whether to Issue a permit. I further acce t all <br /> P 9 P Y ty 9 P <br /> liability that may be a result of the County of Burnett relying an this Information on I am providing in this application. I agree to n n`^ <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above � (•j <br /> described premises at any reasonable time for the purpose of Inspection. 09 c)d o =' <br /> OWNER'S SIGNATURE s,�/ m 6 n d z <br /> I (date) � yq . $� � <br /> ZONING ADMINISTRATOR ��M" 1 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N <br />