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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER_� -�_ '.' �F-�►t�rl� �5�+)�ELCCI.�Ii)L�`'n�l'$�— _ —�-... <br /> MAILING ADDRESS !EaNjn` _ <br /> PROPERTY ADDRESS - <br /> - -��S'i�o "Mrat�ai�v���#L•!—�! ,�,� , �..gelr.,gLeP,_W�,n_ __ � <br /> LEGAL DESCRiPT:ON SV \� <br /> �ol_._.Ln Go u• L oT {Yo N 3G-.r* /U , ISco, �.cKsw v ' <br /> TYPE OF PERMITS): SINGLE-FAMILY DWELLING ❑ ADDITION - DECK GARAGEiACCESSORY STRUCTURE C 6 <br /> BUNKHCUSE= S9.G92(IV)GAZEBO ] STAIRS C F1 1-1%G,GRADING❑ CAMPING UN;T <br /> COMMERCIAL BUILDING C COMMERCIAL ADDITION 7 COi•1MERCIAL ACCESSORY STRUCTUREE :_1 <br /> STRUCTJRE)ADDITION USE:,dc[Q06, AfQ I./Qp(IA6.11E.Se''+_d-(64 G1Cgl-ow_ �W.pt..�Cx L�FQe�' lLl <br /> (Home/Catrin; Corin-ercial Bismess; Bedmcm; Deck, etc <br /> BUILDING CONTRACTOR: "A To <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8%X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) - -_ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS,'STRUCTURES(EB)AND ALL NEV•1 Q <br /> BUILDINGS/STRUCTURES(NB).INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH(114). Q _ <br /> i. SHOW DIMENSIONS IN FEET CF THE POLLCWING: (A)BUILDING;Sr TO AL_LOT LINES. (B) BUILDING($) '- ) <br /> -O CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK ) O <br /> (OHWA)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D) _OT DIMENSIONS. <br /> 4. SHOV.'THE LOCATION OF THE WELL(1'1), SEPTIC TANK(5T) AND DRAI`.FIELD(DF,AND ALL DISTA'ICE5 r O I <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. t N <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. - t <br /> 6. IF SEPARATE PIANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE <br /> PIANS MUST BE SIGNED AND DATED BY THE OWNER. 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN — <br /> NEEDED. p ) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: C?I - t7 <br /> Svu <br /> ! DRIVEWAY MUST FLEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 6C DAYS OF PERMIT. <br /> ' REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHOREIAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. SL ^ p <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC., ALLOWED'WITHIN THE REQUIRED:'DATER O Ull (S <br /> SETBACK AREA. 0' O <br /> 5. ACCESSORY STRUCTUREIGARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE!STCRAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 1 declare that this application(including any accompanying schedule)has been examined by me and to the best of my .r 1 F_ j 7 = <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all <br /> information contained In this application(including any accompanying schedule)and I further declare that I recognize that this <br /> information I am providing will be reli d upon by the County of Burnett Wisconsin in determining whether to issue a permit. I <br /> further accept all liability that may be A result of the County of Burnett relying on this information I am providing in this f7 7 <br /> f7 v I= <br /> application. 1 agree to permit county officials charged with administrating county ordinances or other authorized person to <br /> have access to the above-described preinises at any reasonable time for the purpose of innssp ion. <br /> OWN£R'SSIG UTNA RE <br /> \ '7� ���\ ' �N date) ;1 _ <br /> ZONING ADMINISTRATOR lO <br /> TOWN IP PERMITS MZBE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> � f f = <br />