Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator o 3 <br /> APPLICATION FOR LAND USE PERMITS H h <br /> / o <br /> OWNER PA.vL L� r t A 5ely S 2, TELEPHONE 7l) e��&- 7L d�O �• <br /> MAILING ADDRESS ���� MiSS <br /> C'oo/l /° ✓1�//�S /i/Ij� J L/.iJ �, ''�J <br /> PROPERTY ADDRESS7-,�-bT� /1 CvO/y <br /> f'i <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMrT(S): <br /> FILLING/GRADING 0 CAMPING UNIT 0 BUNKHOUSE 0 59.692(1V)GAZEBO 0 DECK 0 <br /> SINGLE FAMILY DWELLING 0 GARAGE/ACCESSORY STRUCTURE 0 ADDITION Z STAIRS CI <br /> STRUCTURE/ADDITION USE: H 011 :� Or <br /> A <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) z <br /> BUILDING CONTRACTOR: O j' <br /> OV 7;2'1 rN tfJ / ;YJr?L <br /> A PLOT PLAN MUST BE PROVIDED ON AN B Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O <br /> WILL BE RETURNED. 70 ¢ 4-- <br /> DIRECTIONS <br /> CDIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) I o <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. f1 <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, 'a c <br /> AND INDICATE NORTH (N). J c <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK S P <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. = �, <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES C <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN o Q <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS 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. O C <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. tae <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER E a ('ti <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge T m m o n o �o <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all information R n y v Z a F7 <br /> contained In this application(including any accompanying schedule)and I further declare that i recognize that this Information I <br /> am providing will be relled upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accept allliability that Mat may be a result of the County of Burnett relying on this information I am providing In this application. I agree to <br /> Permit county officials charged with administrating county ordinances or other authorized person to have access to the above- n ��`, - a <br /> described premises at any reasonable time for the purpose of Inspection. U, �^ <br /> T/ �� Np�W Jorma <br /> �1� p Q RV'�IAO InNOr <br /> OWNER'S SIGNATURE �io�//�Lt/•lij /,� - 8-�'p [3 <br /> 0 <br /> N w C a <br /> �� ^ [� n �7 (date) rt n �E <br /> ZONING ADMINISTRATOR \ ) 1 ! i 111 o f oa r\ o v, �a„c a z <br /> Q N' aw K7 <br /> TOWNSHIP PERMITS MAY BE REQUIRED c <br /> TH S PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> �(rYtii +- ,4 �Ct� li t /yet [ -aW ow <br />