Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER p <br /> s n <br /> T�iiQ j rli ( Qom, I, 6tw_ ,2/_( E HONE �6/a 1 Sas-e3o� <br /> MAILING ADiSRESS' '2903 '_"�' '� Lk'Icq, T-"9�'—� IC " g <br /> 1136vrl- ,fef PL iP Or. SQ _MA/Ss9 <br /> PROPERTY ADDRESS <br /> - 4�- doe P /a.t'? &,,j t,w SIS, e^P� l.[/Z �'i�S�D� o � C <br /> LEGAL DESCRIPTION c <br /> PAri"AY' S %a df /SeS lLy l9 hyo � <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION[IDECK IJ GARAGE/ACCESSORY STRUCTURE ❑ v� <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ 9 S <br /> ro <br /> COMMERCIAL BUILDING tsk COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ c <br /> STRUCTURE/ADDITION USE: � j e l m T P z <br /> (Home/Ca in; Commercial Business; Bedroom; Deft .) <br /> BUILDING CONTRACTOR: O <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Ys X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o <br /> WILL BE RETURNED. 2. y <br /> C <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. [ a <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW 'b <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, 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)BUILDING(S) 0 0 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. O p <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. rn <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE I\ r <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 9.J <br /> NEEDED. <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: n <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. ❑ z ` <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER 9 I\ O <br /> SETBACK AREA. I <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. <br /> 7y 9r� � nA 7 <br /> " 33g6ei <br /> [declare that this application(including any accompanying schedule)has been examined by me and to the best of mym <br /> knowledge and belief R is true,conect and complete. I admowledge that I am responsible for the detail and accuracy of all c w E, <br /> information contained In this application(including any accompanying schedule)and I further declare that I recognize that this " _.a a m <br /> Information I am providing Will be relied upon by the County of Bumett Wisconsin In determining whether to Issue a permit. I ii R 24 <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing In this ,, �. N <br /> application. I agree to permit county ofBdais charged with administratingcountyordinances or other aut hortzed L]S s t" <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. person to have S S 8 8 N N <br /> "i1 " '8$c88 <br /> t2 <br /> OWNER'S SIGNATURE � �- �_ ,. � ,^. o.yy g �+ <br /> i (date) <br /> ZONING ADMINIST�TOR ;;;:: <br /> yU� - Cao SL] ts1 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> (A U O p O p <br />