Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a 3 <br /> APPLICATION FOR LAND USE PERMITS <br /> r W <br /> OWNER On „ / � (;n?'/ <br /> nL�� TELEPHONE <br /> MAILING ADDRESS 2 <br /> 2 n 66An hi I ` <br /> n <br /> n <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION ^. a <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ADDITION O DECK O GARAGE/ACCESSORY STRUCTURE 0 c �� <br /> o ` <br /> BUNKHOUSE O 59.692(1V)GAZESO CI STAIRS O FILLING/GRADING O CAMPING UNIT O <br /> COMMERCIAL BUILDING p ,CO/MjMME�RCIALADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE 0 ' <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) ° <br /> W �1J <br /> BUILDING CONTRACTOR: iUl J <br /> OT 3 I� <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 r/a X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS c �'DO <br /> WILL BE RETURNED. - T — <br /> r I n (ll <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) r a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. y I T r <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW n <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) T-' <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. O <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES I Q <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. a -C <br /> n <br /> S. 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 o SJ <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> J <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. _ <br /> jC <br /> THIS PERMIT IS SUB7ECi TO ALL CONDITIONS LISTED BELOW: 61 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. o N <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 $u <br /> SETBACK AREA. G � a <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. I <br /> NOT TO BE USED FOR HUMAN HABITATION. O <br /> 6. E C' <br /> 7. o <br /> nn �' <br /> X 3 'A = xi <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my 3 e a <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all .3 <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this E. <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I .'3. £- 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 <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have ^ p <br /> access to the above-desalted pre reasonabl for the purpose of inspection, to w ' �,* W n <br /> OWNER'S SIGNATURE /� Z,p'6 a >'c <br /> (date) > <br /> o H g> <br /> �i/o� c 3 a = Z <br /> v <br /> 20NING ADMINISTRATORS -��I n < U �' c 1-1 <br /> i trIj <br /> C. A c : ,a til <br /> TOWNSHIP PERMITS MAY BE REQUIRED a <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF SS <br /> UANCE =N H ^ <br /> +mi� � 12� rCQ�lu� �yne_Cc � Cc�r rrso� s <br /> ?av-ag <br />