Laserfiche WebLink
G z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS N <br /> OWNER TELEPHONE <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS <br /> L /UY.QABTOIZ. : N WV� • t-QlT �� 1�—��I ��� I'S <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 1:1 ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ r <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDINGV COMMERCIAL ADDITION ElCOMMERCIAL ACCESSORY STRUCTURE <br /> TElRUCTURE S' <br /> STRUCTURE/ADDITION USE: e0l/17/h(�eLeLo G - (C),CFIO („PE,4-/ /0/v z <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) P <br /> IIUI.6 seQ,��,Oae iu 9 y &) _ our GoT-q <br /> A PLOT PLAN MUST BE PROVIDED ON AN 81/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o <br /> WILL BE RETURNED. FF _ T6 — 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. C O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW tV'r, jw `% o <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, a <br /> AND INDICATE NORTH (N). N z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S) TO ALL LOT LINES, (B) BUILDINGS) a <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w' <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p <br /> 4. SHOW THE LOCATION OF THE WELL (W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES <br /> y <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 '�- <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. lJ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN 1 y <br /> NEEDED. <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z <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 <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. AS ou_+1ir1t_d 6n varianG2.*951 w4h i%om condihLns <br /> 7. " � 000N � Fij <br /> . , R333 o' cF <br /> 7. o rn to g o o F. <br /> I declare that this application (including any accompanying schedule)has been examined by me and to the best of my 3 p g o <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 1 further declare that I recognize that this f° E. D > to O <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I fo a - <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 chad with administrating county ordi antes or other authorized person to have <br /> S R o o <br /> access to the above-described premises at any rea ble time for the purpose of I coon. > <br /> ' A9 rt a c <br /> OWNER'S SIGNATURE �_3 )C7 tp y ,� <br /> I y� I {-� �/� /-� (date) o a o c B E <br /> ZONING ADMINISTRATOR �1� I J 'F l ar f i f/I(it.r ) 0 y °w o_n <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHAL EXPIRE ONE YEAR FROM DATE OF ISSUANCE p/ N o s N <br /> �Z�rnt � �t �e p1C�e� up 10 L/ Cirai) 4 trr,CY � � o00os <br />