Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Adminitator z <br /> APPLICATION FOR LAND USE PER g . <br /> OWNER `$ <br /> 0jWj 2� �L TELEPHONE <br /> MAILING ADDRESS 4z'70 ^ o <br /> v✓ £o <br /> PROPERTY ADDRESS , I r ' 1 I <br /> -12 <br /> LEGAL DESCRIPTION S J T,39N /� ��jLrl��7�t1 p r 8 y�J <br /> TYPE OF PERMIT(S): SINGLE FAMILY DWELLING ❑ GARAGE/ACCESSORY STRUCTURE,rgf ADDITION 1:1STAIRS C3o <br /> FILLING/GRADING❑ CAMPING UNIT❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DE K❑ <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) c <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT 2LANS <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) ^ a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. d <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW y I 6 <br /> BUILDINGS/STRUCTURES (NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, m w <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDI G(S) I n <br /> TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 3 <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS. '51 <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES o m o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. w <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. t7 c <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE I <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> JjH <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE W IEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> r <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 3^'c A <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <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 C NLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> ^ � aaoro <br /> 7. mA 9.g M <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my knowle ge <br /> and bellef It Is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of all Information a <br /> contained In this application(including any accompanying schedule)and I further declare that 1 e <br /> recognize that this further <br /> I Y <br /> am providing will be relied upon by themo County of Burnett Wisconsin In determining whether to Issue a permit. I further ac all =w 0 7 <br /> liability that may be a rewlt of th of Burnett relying on this information I am providing In this application. I agree to <br /> permit county of iclals tllargad adml trating mumbf ordipances or other authorized person to have access bo the above- e n <br /> described premises at any me nable time r I spection. W ^ c= y <br /> OWNER'S SIGNATURE <br /> w <br /> �T/�/�/� <br /> ZONING ADMINISTRATOR u/I r i o -a - <br /> a <br /> 04 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> N: flf: <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N o o <br />