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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 ci Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> CD <br /> CD <br /> OWNER JaV'j AlMlie and Alayliun '\c pf TELEPHONE(71J 3a7—y381 p \' <br /> 4 Grs r•11 i"� I B <br /> MAILING ADDRESS /QAC 5121 �4Ke �}ccess �iaad? 1�fZ�LltGf I C ( '�N�57 <br /> 7 r <br /> O <br /> PROPERTYADDRESS <br /> Lot 8, )oa�ers Be17k , Qu rr,et( Ccu�/./ Gav Lat at secttc., IO, <br /> LEGAL DESCRIPTION(see tax receipt) Tow n.skie 37 Nby tTl ci Qc, e, a g4, elt Coc } + LSI \ <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE 56 ADDITION ❑ <br /> TYPE OF PERMIT(S): co <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n <br /> STRUCTURE/ADDITION USE: ra �0.u48 GN, S:JB�ee 0 <br /> (Home/Cabin;tommercial Business; Bedroom; Deck; etc.) m ti <br /> BUILDING CONTRACTOR: C9 Pi 1 4 e N AO QV 111 L✓P 1 YI Z I C Y l m Q J <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLOR CDr , <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p/ e) VAI <br /> �'e t° l/c�G/rai ET b cv / W N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m J <br /> n o r� <br /> -n Z \ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C Itn <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD, (C) BUILDING(S) MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF \C� Z <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. -� o <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO rr'' <br /> BUILDINGS, ROADS, LAKE, LOT LINES. rte. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N r `V <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS 0 Wr <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> O � <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a o <br /> NEEDED. Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> = <br /> CONDITIONS OF PERMIT: o ((` <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT Z) +.Z <br /> ISSUANCE. I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 0 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. " O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER �1 <br /> SETBACK AREA. This structure to be used as Private residential <br /> 5" garage/storage only. Not to be used for human <br /> X mC)r- DODO 'V <br /> s. habitation. CD C 3 a rn <br /> a <br /> o m C y o 3 <br /> 7. Z c y o <br /> m <br /> I declare that this application (including a,. — <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m �_ c <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m c m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m cn <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am w o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other n m <br /> authorized person to have access to the above described premises at any reasonable ' m D <br /> n : <br /> \ ai <br /> SIGN HERE D a <br /> (si u e of own r Iding ntractor) ( ate) <br /> ZONING ADMINISTRATOR JUN 2 .9 2465 <br /> rn iA iA isr <br /> FA EA'A <br /> �Vi -+ N <br /> TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY o o o <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANOONING <br />