Laserfiche WebLink
C n O <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a <br /> APPLICATION FOR LAND USE PERMITS N H <br /> 61I-)L <br /> TELEPHON <br /> OWNER C (,ia _38�_4(ola d <br /> MAILING ADDRESS / ^/� II ''3�'ra 'S5443 <br /> PROPERTY ADDRESS 3oa 1r:�am'e� Lk UR\d, �anburV I <br /> LH <br /> n <br /> LEGAL DESCRIPTION Sas 7-41n tbo, FiYs51 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION 0 DECK GARAGE/ACCESSORY STRUCTURE 0 --ti <br /> BUNKHOUSE 0 59.692(1V)GAZEBO ❑ STAIRS 0 FILLING/GRADING ❑ CAMPING UNIT 0 , <br /> v <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0-DivS <br /> STRUCTURE/ADDITION USE: L o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: InY' N <br /> 0 � <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o <br /> WILL BE RETURNED. c <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) O <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 NEW M " 9 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). 0 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. C7 <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES _ i <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. Ih , <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. I'"/11 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n <br /> F <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. d <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. y L <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. on on.0 <br /> E <br /> 6. <br /> 7 F/f�3(T 5�� /)�I'7 MI5 Q f" Y�C'1� Co C. ^ 1° 3 3 3 _'a tc�`�y� <br /> w � on � $Op rS <br /> I dedare 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 K m <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this c y <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to issue a permit. Ie S w w 5 b <br /> further accept all liability that may be a result of the County of Burnett retying on this Information I am providing In this = g »N: 8 c 'ti <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized Person to have $o r. <br /> access to the above-described premise at any reasonable time for the purpose of Inspection. 8 p pp m 5 w N n <br /> y <br /> n <br /> OWNER'S SIGNATURE (date) g g$ nsr 7 <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL IXPIRE ONE YEAR FROM DATE OF ISSUANCE — »';',"8»» "— <br /> vJ, . $0008 <br />