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y � z <br /> n o <br /> g � <br /> Burnett County 7410 County Road K, No.102, Siron,WI 54872 Office of Zoning Administrator =: <br /> APPLICATION FOR LAND USE PERMITS a <br /> CL <br /> oOWNER TELEPHONE OL&Av\CA- �AV C � IIMAS -13 <br /> O <br /> MAILING ADDRESS aL435'S �-SQ" re. Qiud FureA l,.Ak--z-ynv\.S5c.S' <br /> PROPERTY ADDRESS a g 5 8 y e �.n�� RoA 17 l0e bde, 101 S 4 913— <br /> 0 ,1 F 1 —ol ;E- or5 18-5 fB—S- aS- o►'� - �1 r �000 s <br /> LEGAL DESC91 <br /> RIPTION / / 0 Y Q � w � �o (o V Lot I1l—1 <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING❑ ADDITION❑ DECK❑ GARAWACCESSORYSTRUCTURE <br /> CK <br /> BUNKHOUSE❑ 59.692(1V)GAZEBO❑ STAIRS❑ FILLING/GRADING ❑ CAMPING UNIT❑ ,a <br /> s <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ 3 <br /> STRUCTURE/ADDITIONUSE: SNCTINvYw�uI2 �LA(�J4LVV\'UWtIr StOLrAaP, ° <br /> (Home/Cabin;Commercial Business; Bedroom;Deck,etc.) <br /> BUILDING CONTRACTOR: Se.I�Wn HYD LOm S-Ev'I.f L��/ ✓'�.S Z.U�. <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Va X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS h <br /> WILL BE RETURNED. S. <br /> n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m <br /> � O <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, \i v <br /> AND INDICATE NORTH(N). d S' z <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 <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. k g <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DFS,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. c <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE "L 1 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. T1 <br /> ca <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAND SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> r <br /> THIS PERMIT IS SUBTECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 1 n Y Y <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. P <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 d <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. E <br /> 6. <br /> 7' ori n333na _ � <br /> I declare that this application(including any accompanying schedule)has been asamdned by me and to the bast of my <br /> knowledge and belief It ls troy 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 achadule)and I further dadere that I recognize that this <br /> Information I am prevWing will be relitl upon by the County of Burnet Wisconsin in determining whether to Issue a permit. I <br /> further accept all uabRRy that may be a result of the County of Bu.. relying on this information I am pro"Wing in this Yr 26 <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to 8 <br /> hew access to the above-dendbed awry isle time for the purpose of I 5 g ` y;> <br /> 5_! w 8860 � <br /> OWNER'S SIGNATURE — m ago <br /> (date) � v a? ro 4c2 <br /> a g <br /> ZONING ADMINISTRATOR <br /> WNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE . <br />