Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator �^ <br /> APPLICATION FOR LAND USE PERMITS P <br /> a <br /> OWNER TELEPHONE <br /> �� 4 ¢a.t on1 952- z92--7e39 <br /> MAILING ADDRESS f dA) <br /> n <br /> PROPERTY ADDRESS —�- <br /> 29 Zg 8 }J(6KUA^ lav / Q< uJk✓ — r�DwJ + P g <br /> LEGAL DESCRIPTION <br /> DWELLING/BU LDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION [ISTAIRS ❑ S E <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ �CAMPING UNIT ❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK ❑ n <br /> STRUCTURE/ADDITION USE: .`a ti'E 4 z <br /> `` ''�'(Home/Cabin; Commenrcial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: F-*Ifytxl Evu/rJ ` o <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS a w <br /> WILL BE RETURNED. O� w <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) o <br /> m _ "c <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. P^Oe <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW to IV ?I <br /> BUILDINGS/STRUCTURES tNB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, h1 <br /> AND INDICATE NORTH (N)'.. <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) o <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENTS)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM) OF LAKE, STREAK( OR RIVER AND MEASUREMENT TO WETLAND AREAS. L <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES m �' o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. x <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ry _ <br /> NEEDED. o O <br /> T <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> B > <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. 3 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER v <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. (Y) I-fl� ,{Q-. 21QI _6`om jr-alit e_10`r(nLt,_E V)'1@C-� 6,till Of!'1Pr <br /> T. SLack igtA nY/htn 13 , �� QYg v <br /> 2 <br /> I declare that this application(Including any accompanying schetlNe)has been examined by me and to the best of my knowledge 3 " G K N <br /> and belief It Is true,correct and complete. I acknowledge that I am responslble for the Eetall and accuracy of all Information $' 7 �' N <br /> a .° — <br /> contained In this application(including arty eaompanying uhedule)and i further declare that I recognize that this Information I n �+ �, b <br /> am providing will be relled upon by the County of Burnett Yvlsconsln In determining whether to Issue a permit. I further accept alltn <br /> liability that may be a result of the County of Burnett rclying on MIs Information I am provltling In this application. I agree to c N 8 N u o N <br /> permit county officials one IM adonhistrating co ordinances or other authorized person to have access to Me above- S n <br /> described premises at a re nable time for the r se of Inspection. o n o a .>. <br /> SIGN HERE / 5fri <br /> g > <br /> sipnatu f. boleti g contractor) tla[e) Y a <br /> 7 3 w n g Ee <br /> ZONING AD I, TOR �l /�• Qn <br /> _ a <br /> B , <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXP RE ONE YEAR FROM DATE OF ISSUANCE v 6a o U o <br /> Perm I e re fna i li-d 4o Daren Benson <br />