Laserfiche WebLink
y t Z <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator < <br /> APPLICATION FOR LAND USE PERMITS 1 <br /> a <br /> OWNERo - TELEPHONE <br /> MAILING ADDRESS S. J 6/ <br /> fV <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION 6 <br /> / o Cc1 <br /> v(_ N <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK IX GARAGE/ACCESSORY STRUCTURE❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ A <br /> COMMERCIAL BUILDING❑ {COOMMER/CIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ ° <br /> STRUCTURE/ADDITION USE: 0 <br /> (Home/Cabin; Commercial B ^ss; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: -� . - Z �` ��J7" r�t��— N C. <br /> E7c�� ti ba-s—, 101 tmS4 41uls-a ° o <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 XL SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. <br /> n a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m <br /> d <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. oro <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW o o <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, _-Z <br /> AND INDICATE NORTH(N). O <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S) Oo E c <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 1 00 b <br /> (OHWM)OF LAKE, STREAM OR RIVER AND WETLAND 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 PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE l, (� <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE DONE WHEN 1 <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: X �' <br /> ro <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. m Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. �j a <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. .ILS <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. p <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. (y <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. xlann nnaoro <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this " E.3 D m `O <br /> information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I ? $ a= Y <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this <br /> application. I agree to permit county officials ch rged with administrating county ordinances or other authorized person to C) = <br /> have access to[head premise at n sonable time th urpose of inspection. o y o <br /> OWNER'S SIGNA URE \ C�.)_/ 3 Yy y H° o 0 0 0 o y <br /> mo 0 <br /> (date > <br /> n vz c � _ O <br /> ZONING ADMINISTRATOR 5APR 10 20 7 0 =r <br /> ZONING H �' ^n <br /> o cw 6rr1 <br /> 12 <br /> TOWNSHIP PERMITS MAY BE REQUIRED �I ETT `" <br /> COUNTY <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSO1kiWIM NO i <br /> L <br /> 69 � NTA fA FAQ <br /> u tNii O o O O O <br />