Laserfiche WebLink
_-------------------- <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Adminlstr r v Z <br /> _APPLICATION FOR LAND USE PERMITS a <br /> OWNERd-�/��./p�� 17?ore(li TELEPHONE <br /> �f e- d <br /> MAILINGADDRESS �� �� 3�d /I ✓/L /l�l� �'/ _� ,YI-�� ��� �,p� <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION J <br /> SINGLE FAMILY DWELLING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION 11 STAIRS—El o .� <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK ❑ 4 <br /> STRUCTURE/ADDITION USE: V Z- d 1G" q " e 0n ` Z <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) o ° <br /> BUILDING CONTRACTOR: <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT P NS <br /> WILL BE RETURNED. O <br /> � < O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) c M� <br /> ti 6 \v <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. d \ <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW n <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, to <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDI G(S) '� n <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK Ci a <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. N �, <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD (DF), AND ALL DISTAP CES o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. a'o <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., HE _ a <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. A <br /> NOTE: NEEDEDG/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE ffl EN i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: L, <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. Z J <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. f7 F 6 <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. F <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER ((((JJJ�yyyy <br /> SETBACK AREA. W l <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ILY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> DhW ODO �o <br /> 7. xA y9sxa � <br /> w Oo <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge y a �, P y <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information c <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Information 1 <br /> am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accepil all o N 0 7 <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree to m n o `^ <br /> permit county officials charged with a istrating county ordinances or o er authorized per to have access to the above- <br /> described premises at any reasons 4,,,ehe purpo f Inspection 3 s >0OWNER'S SIGNATUREn (date) o' a 5ZONING ADMINISTRATOR f Y ��LC (• n W: �A M <br /> y < p <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE o w o <br /> Permi4- a-IV_t4e/ piCred 1410 bLI A)&b tVloref! 1C,-I 6 <br />