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Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator `g a <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNERTELEPHONE o , <br /> �'R1Q1J 1nR�ts� Cnl2 - p1�7--337-7 � �y9 <br /> MAILLNG ADDRESS Z-77�/rv'� --en't-:5 M(e7aJ QC3�p L � .QI Wl `en't:5 v f, <br /> �- 3 1 <br /> PROPERTY ADDRESS <br /> 272oq 6hrT���o,J Rc�7 (,Yr��i2, w `yfAQ3 � ) <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMUTES): SINGLE-FAMILY DWELLING AI ADDITION 11 DECK D GAGE/ACCESSORY STRUCTURE D <br /> BUNKHOUSE D 59.692(1V)GAZEBO D STAIRS D FILLING/GRADING D CAMPING UNIT D �P <br /> 9 <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ S 9 <br /> STRUCTURE/ADDITION USE: ILDM'E tDJ T <br /> (Ho me/Cabin; Commercial Busipness; Betlroom; Deck; ea. <br /> BUILDING CONTRACTOR: O(=gI2)Cl( (LL9+kj T �- O <br /> �i a awl- 3 <br /> A PLOT PLAN MUST BE PROVIDED ON AN B Vr X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PUNS o_ <br /> WILL BE RETURNED. 0 <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C v O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW w <br /> RUtLDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, c' <br /> AND INDICATE NORTH (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 U �' <br /> (OHWM)OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS. p d <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. Y. S. <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 III\-\ <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. Q, <br /> NOTE: BUILDING/STRUCrURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ( y <br /> NEEDED. A <br /> THIS PERMIT IS SUB]ER TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ,2 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I F <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. Q, _ <br /> 4. NO STRUCTURES; INCLUDING RETAINING WALLS,, ETC, ALLOWED WITHIN THE REQUIRED WATER - A)' - - — - <br /> SETBACK AREA. d <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. (pj <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. E <br /> 7. A >7i �3@o LL$> S <br /> 1 dlrsane Met this applixtbn(ImIteEI g srhy aoompenythg adlwlhde)no been exambwd by me and o Uhe bx of my <br /> WwwWW and belief It is true,pprrKt Orhd omphbe. I wknowledge that I am leswnsIft for Ne d Ii am!amemy of all <br /> nftm ion mnpIw in this aPPllmton(I.daCing eM acmnganNnp ad*dule)and I further dedara tat I remgnbe Nat Nh <br /> InronnaUm 1 am prwi&V WII be MEW upon by to CimAy of Bha.elt Whored.In dnennlnbho whCMr o Imre a pinna. 1 v P< 1 S <br /> auNvr amept all adRy Net may oc a reHdt of the Ooumy efBumf[rtlykp on Nla 1 am dl In Is <br /> APPikaton. I agree o permit oumy ofllCals Charged w a Iminweatbhg oun[y oNpho <br /> lns ` <br /> eo:z9 o the above-deevfbed Aany tme Tor Na Wrpom or bupedtkm. —I- � ® eggs ^ <br /> OWNERS SIGNATURE -- �'� y > ;m C <br /> ZONING ADMINISTRATOR B w <br /> BURNETT-COUNTY B ' ;; <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE „N3 u 812 112 8 <br />