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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 /> OWNER TELEPHONE <br /> y_ "r �` , �L )� < T[LEPHONE S\2- `4 <br /> 0L- oT. <br /> MAILING ADDRESS --20071) <br /> PROPERTY ADDRESS 2Zohh R=�Cbtf4+1J <br /> ''--__ 11 <br /> LEGAL DESCRIPTION Pa�.w; IN IJ�N. f-Ot SEC 2 . 'E 3-7 n,- RfELJ - <br /> TYPE OF PERMITRU: SINGLE-FAMILY DWELLING GC ADDITION U DECK ❑ GARAGE/ACCESSORY STRUCTURE U l� <br /> BUNKHOUSE ❑ 59.692(IV)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT D ,j h <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION U COMMERCIAL ACCESSORY STRUCTURE ❑ o <br /> STRUCTURE/ADDITION USE: <br /> r _ <br /> -J---�-" _—=--(Home/Cabin;•Commerciaf Business; Betlroom; Deck: eta.) <br /> BUILDING CONTRACTOR: 5�.iz�(-Vyor c55 <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1h X11 SHEET OF PAPER, ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS z <br /> WILL BE RETURNED. _ _L <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2, SHOW THC LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECK5, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) 6UILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENTS)TO THE ORDINARY HIGH WATER MARKHOHWMU <br /> 4, SHF <br /> OW THE LOCATION OFhTIHE WELL IW),R RIVER EPTICT NK (ST) AND DRAINFFIELD HOT)WETI-AND AREAS,AND(D) LOT ,ND ALL DISTANCES <br /> TO BUILDINGS, ROADS, TAKE, LOT LINES. <br /> 5, INDICATE IF A WALKOUT BASEMENT15 PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. V <br /> 6, IF SEPARATE PLANS ARE SUBMITTED By AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE � q > <br /> PIANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN t <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ct V <br /> 1. DRIVEWAY MUST MEET DRIVEWAY NREQUIREMENTS WITHIN fib DAYS OF PERMIT. , <br /> 2. REMOVAL OR CUTTING OF TREES ANDD VE VEGETATION 15 RESTRICTED ALONG SHORELINE. <br /> 3, NO GRADING TS SHCLUDING ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. $$77 <br /> -4--NO ETBACKREA. INCLUDING RETAINING IVALLS, ETC ,.ALLOWED WIIIIINTHE.HEQUI0.ED.WATER_. _ yJ_ <br /> SETBACK AREA, h` <br /> 5. ACCESSORY SED FOR HUMAN HA PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY, <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> I declare that this apPlazi(including any accompanying scnedcle)has been e.ammeo by me and m In,best or my = c <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am resvonslbie for we aetaa and accuracy o/all <br /> 'courni amtomed m ins avprcatern(Including any accompanying schedule)and I wM1ner declare that 1 recognize that this <br /> further.,,I am proyimng <br /> further accept agI y that may <br /> rebelieas rureportont by the <br /> e Ccoouunttyy of <br /> f Barren,relying rweliyi nng on this <br /> Information <br /> nfor o I am Wros misinsug in <br /> This <br /> cr, <br /> avvrmaunn. Iagee to Permit county officials charged with administrating county Ordinances or other authorized person nage _ - " -Ic _ - - <br /> access to the above-descnded premises at any reasonable time for the purpose or inspection. _ — _ <br /> OWNER'S SIGNALER <br /> E_Zq _ <br /> V (date) :R <br /> r� _ <br /> ZONING ADMINISTRATOR_ -ta _ECEIVI L, <br /> TOWNSHIP PERMITS MAY BE REQUIRED D �[ <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF I Na 15 2013 <br /> Utis15k-�OE q-/5'l3 - <br /> MA0Shames AJOOIlti BURNETTCOUNTY <br /> -- ZONING <br />