Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator ; c <br /> APPLICATION FOR LAND USE PERMITS g loj <br /> OWNER / e , 1p, /—!— // TELEPHONE r <br /> ,/L�(/VL(//� ff f l -1— <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS <br /> ✓ l �-f- t ) lJ J a <br /> LEGAL DESCRIPTION J <br /> 9 <br /> TYPE OF PERMIT(S): SINGLE FAMILY DWELLING ❑ GARAG ACCESSORY STRUCTURE O ADDITION ❑ STAIRS ❑ o <br /> FILLING/GRADING 0 CAMPING UNIT BUNKHOUSE 0 59.692(IV)GAZEBO 0 DECK 0 ° <br /> STRUCTURE/ADDITION USE: C — Oc aG(]1) I� z <br /> (Home/Cabi ; Cqrryherc Tal Business; Bed om; Deck; etc.) o P <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yx X11 SHEET F PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. K ' <br /> o � <br /> DIRECTIONS FOR PLOT PIAN DRAWING: (ARIAL OR TOP V EW) 0 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. W a <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING I BUILDINGS/STRUCTURES(EB)AND ALL NEW C ' <br /> BUILDINGS/STRUCTURES (NB),INCLUDING DEMO, PORCHES AND OTHER STRUCTURES tysi 'e <br /> AND INDICATE NORTH (N). ' <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: .(A) BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S) c <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASURE MENT(S)TO THE ORDINARY HIGH WATER MARK W e <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAP D AREAS,AND(D) LOT DIMENSIONS. N ur <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC T kNK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES R. o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED A NO SHOW AREAS TO BE GRADED OR FILLED. C e <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWN R. P. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAK�D SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED, I� O Q� <br /> THIS PERMIT 1S SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. N O <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. r1 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE A.LOWED UNLESS SPECIFICALLY PERMITTED. i <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ITrC.,ALLOWED WITHIN THE REQUIRED WATER V} <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. O <br /> NOT TO BE USED FOR HUMAN HABITATION. E <br /> 7. <br /> S w <br /> Ind daro that fhls ,correct <br /> a d(includingcoole any amomwledge that <br /> Iamschedule)has been examined by me and u the best of or knowledge <br /> and belief it ls true,mrrett and complete. I acknowledge tM!1 am nsibls for the detail and accuracy of all Information e <br /> contained in this application(Including any accompanying schedule)a id I further declare that I recognize that this information I <br /> am providing will be relled upon by the County of Bumett Wisconsin h determining whether to Issue a permit I further accept all <br /> liability that may be a result of the County of Bumett relying on this It formation I am providing In this application. I agree to <br /> permit munty officials charged with administrating county ordinance a other authorized person to have access to the above- 8 "" <br /> described pramWs at any reasonable time for the purpose of Inspectl in. v,w E y <br /> OWNER'S SIGNATURE �l <br /> (date) ine 6 <br /> ZONING ADMINISTRATOR Qj $ x.00 CzI <br /> TOWNSHIP PERMITS M Y BE REQUIRED (A ' <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />