Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNERfTELEPHONE ("r an+hbnu d- �hQuvlJ?hrzs6r, e (WI <br /> MAILING ADDRESS <br /> N ( 1VerVZ� /JQl1G�try w� 5 830 ; <br /> Gpp <br /> PROPERTY ADDRESS O� l0 Nh 1�21e/' <br /> / !D o i <br /> < O <br /> LEGAL DESCRIPTION c <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE tot <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> a <br /> COMMERCIAL BUILDING�❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o 5Z <br /> / <br /> STRUCTURE/ADDITION USE: vara c <br /> (Home/Cabin ommercial Business; Bedroom; Deck; etc.) C) C. <br /> BUILDING CONTRACTOR: n3-) _S <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o _ <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) t�.9 O <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C d <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, O� p <br /> AND INDICATE NORTH (N). N 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 J <br /> (OHWM) OF LAKE,STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. O 1 O <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES X� <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. w (� <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. �I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> i <br /> THIS PERMIT IS SUBIECT TO ALL CONDMONS LISTED BELOW: ) <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. !; <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. " O <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. <br /> 7. > <br /> ' 3 3 a MV <br /> A 6 <br /> P335 <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my '� !"2. <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all n a d. d mit: y <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this '° °9 > m N <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I 5 cw <br /> further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this Q 'e -0 <br /> -0 <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have ° n 0 8 : S S <br /> access to the above-described prem) s at any reasonable time for Me urpose of Inspection. �y /� 9 Y c o 0 0 8 y <br /> OWNER'S SIGNATURE O L � v <br /> --� (date) <br /> ZONING ADMINISTRATOR 1 m r I�a Il <br /> / � _ o . ew _ nntsl <br /> TOWNSHIP PERMITS MAY BE REQUIRED c "° <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE J N« «=' <br />