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•j�00/1Ocf. 6 2014 11 :51AM No. 0314 P, 1 Pago 1 <br /> to <br /> flumen County MID County Road R,No. 102, Siren,WI 540')2 OfHCO of Zoning Adminlutretol• � V 1 � IT <br /> APPLICATION FOR LAND USE PERMITS : ITL <br /> OWNERJI TELEPHONE j • ) <br /> PROPERTY ADDRESS '( 7I()�: . <br /> LEGALDESOUPTION -5e <br /> ice5+ <br /> MAILING ADDRESS <br /> 1)7rr �t•L..[). ..�10 /011), ajO']q or <br /> TYPE OF PPRbiR(S)i �+ <br /> U Single Family Dwelling (OGarage/AccessoryStructure ❑Stairs U Commercial Building <br /> U Addition U Bunkhouse ❑ Filing/Grading ❑Cpmmcldal Addldgn •� <br /> U Deck U(((5///��^ggq��`669912(lvvv...)���Gazebo O Camping Unit Ell Commernal Act.Structure <br /> STRUCNRE/AODITION USE:... \ /lA <br /> J(_Home/Cgbin;Commercial Business;Be4rooD4 neck;efc) a <br /> 9UIlDING NNTRACIO2 r! Jr�+ <br /> fl y <br /> PLOT PLAN--INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. la _ <br /> ***REQUIRED PLOT PLAN INFORMATION*"' <br /> ❑ 81h"K 11'SHEET OF PAPER INSTANCE(IN PEST)TO; � <br /> ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL — <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION U SEPTIC TANK&DRAINFIELD RJ <br /> 4DIrrom ens&Heights U ROAD RIGHT-OF-WAY IF SURVEYED N w <br /> U EXISTING BUILDINGS/STRUCTURES(Includes deck. Porde,eta) -)CENTERLINE IF NOT SURVEYED <br /> -)DIrDBnstans IS Heights ❑ AL1.PROPERTY LINES a y` <br /> G' <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK <br /> ❑ ALL W ELLAND AREAS m ,a <br /> NOTE' Buutling(sWttW2lPrnteln inn:Yee;}.ykCtl(nl'pndlp V(tYin(lUPn wha111C2dOd. ������ <br /> THIS PERMIT IS SUPIECTTO ALL CONDITIONS LISTED BELOW: D D <br /> Removal or eadng M new and vegetatton Is restricted <br /> No <br /> drorellne <br /> No situations(Including Meaning walls,eta)are alloyed uNess as B., <br /> Pens"' - <br /> No ening,grading,or snare lam aftent als oro anowed unlesssPeontaliy Pemetted OCT 6 2014 <br /> Driveway most meet vddih requirements within 6o Jays of Dema[ r- <br /> Arressory slrucNre/garage.Reuters allow rot PlfVato residential=Mae only a` <br /> larag a B IRNETTCOUN' <br /> 'Not m be use[I for human habitation or coccal s e' <br /> I Ueclam that t1a ovPnoean(including anyaccempanying schedule)has here esamhmd by me niW to the erdedge end ['— <br /> belief R Is Our,Colla¢and complete. I atlmowledpe that I am responsible/or the derail and acca,wr of all information contained in <br /> this application(Including any accompanying schedule)and I NM1N dvtivm cart I v mauve Met this iMprmetlan provided War to <br /> ,nlood upon at the county of Anwar Whassain In detaminlnP wbether to Issue a permit I archer acmpt an 6 bildy mar may he a <br /> fth adntha tomeq, hot, <br /> cm cams a, to Mo thmnae l ar ons tolha access <br /> to the n. I agm9 a premises <br /> at May re (hmpae S <br /> wtth to,Me am " county oNinancas dr other aumedzee pespna W nave acus a the above-dNctlbed premises et any reasonable <br /> nm0 to,MO PYNo9e o(In9peRen. <br /> --ADDITIONAL CONDUFI,ONS/—/-' ft 04 <br /> iug <br /> 91 <br /> Y : <br /> ft 6j <br /> / El <br /> /n o s' <br /> OWNER'S SIGNATURE / �i i/ O T Sa m r)o n m <br /> �" (n �I�Tp{jI' to <br /> ZONING OFFICIAL vim+ �Q 1 7�� "I A 6$ F d <br /> --TOWN/UDC PERM3T9 MAY BE REQUIRED -THIS PERMIT SHALL eaplaE ONE YyAR PROM DATE DP IS4UANCC g Lai <br /> on am mxPnnsiblo far complying with state am federal laws concerning consDucum near or on wetlands, lakes, and soemtu. <br /> 16/06/74 10:59 AN Page 1 <br />