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1 <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office Of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS 2.n <br /> OWNER !1 TELEPHONE <br /> cvY �w m IL <br /> TELEPHONE 7[5. 3o8- 5�Or, <br /> 0 <br /> MAILING ADDRESS <br /> IZ./��,.QnS 5117751 � e <br /> PROPERTY ADDRESS L4"2Lc(fp ab )Ccv�1L, IJunS , (✓T SVSf,3t7 _ cJJ , <br /> LEGAL DESCRIPTION GD\(L ,)OF 65 <br /> y- , as 'r'/ 1/ j :R sw (C- <br /> TYPE OF PERM[T(S): SINGLE-FAMILYDWEWNG ADDITION DECK GARAGEIACCES.SORY STRUCTURE �55 <br /> BUNKHOUSE• 59.692(1V)GAZEBO STAIRS FILLING/GRADING CAMPING UNIT J9 <br /> COMMERCIAL BUILDING COMMERCIAL ADDITION COMMERCIAL ACCESSORY STRUCTURE - 3 <br /> /� 0 <br /> STRUCNRE/ADDI170N USE: ( i1�TY�AJl � ' /Yh cial �n 1� <br /> r(Home/Cabin; Canmertlal Burnes;Bed-can; Deck;etc.) , 6 <br /> BUILDING CONTRACTOR_: <br /> z < <br /> A PLOT PUN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. <br /> n <br /> R J <br /> DIRECTIONS f-0R PLOT PUN DRAWING: (ARUL OR TOP VIEW) - <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 NEWn <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, O a <br /> v <br /> AND INDICATE NORTH(NJ. p o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT CANES, T B MARK G(5) <br /> (O CENTERLINE , ROAD,(C)BUILDING WET-AND AREA),A THE ORDINARY NIGH WATER MARK r O <br /> (OHW T OF OCA STREAM OR RIVER AND W TIC TA AREAS,AND(0)LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(5T)AND DRAINFIELD(DF),AND ALL DISTANCES 3 w <br /> TO BUILDINGS,ROADS,LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT PLANNED AND SHOW AREAS TO BE GRADED RA FILLED. <br /> B s <br /> 6. IF SEPARATE PIANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE <br /> PUNS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN D� <br /> NEEDED. O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: C] ? ( <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ) n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I" z <br /> 3. . NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> _ NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER 0 <br /> SETBACK AREA. 1 <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. (] <br /> NOT TO BE USED FOR HUMAN HABITATION, q £ <br /> 6. Q <br /> 7. sA a `Too Pnarm <br /> 1 Jealare that this application(mcludhg any acxmpanyirg z edule)Us been examined by me and N Ne best of my � 6 n n n ii - Ei <br /> K fic, U ea contained <br /> i In Mise,wrcation indudi gang acknowledge Met ule)and Ifo mer scare that <br /> tIrecnd u2ry offMall <br /> IMormamm I am pred i i Nis d he relied upGuby Me c accampaeYhy sdmtem n in l furNer declare he r[ <br /> fnrormatlon[am prosidi will be relied Me recognize Na[Niz = DoGti � Y <br /> rg pon by my of Bunle¢Wfsmrein in dehrminirp whether to Issue a his [ <br /> NrUr ation. t gree to Permit <br /> er it may be a result cl nd al with a minhi matin s unt Nb inances or <br /> lam Providing in Nis <br /> application. lapreabo Prmircauclpremcials charged reasonable <br /> time <br /> for <br /> purpose <br /> se ofin¢sornMer auNartzM person to <br /> M1ave a¢essNNeabovedesaibM premises at any reasonable Ume for Ne purpose of inspection. y <br /> og <br /> OWNER'S SIGNATURE <br /> ZONING ADMINISTRATOR /�`�� <br /> JUN-2 fi 201 z 6 m <br /> v, <br /> WWNSHIP PERMITS MAY BE REQUIRE r o € , <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF EFJRRM COUNTY <br /> ZONING - <br />