Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS a 63 <br /> JOWNER TELEPHONE <br /> T ✓ 1 (_u r <br /> MAILING ADDRESS <br /> O j <br /> DD l7 TGG'K- /� d o <br /> PROPERTY ADDRESSS-5-? 0r 5 I. -7Q J <br /> GO I� O <br /> CA <br /> LEGAL DESCRIPTION3b TW P 39 1& �'L°0 <br /> s'a <br /> 99 Gov t,6+ q Lyg Ndf f�wy 70 E f S.,k. <br /> SINGLE FAMILY DWELLING ElGAR GARAGE/AEE SORY S RUCTURE ❑ ADDITION ❑ STAIRS ❑ <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ DECK ❑ r- <br /> STRUCTURE/ADDITION USE: 1 '4 e-o S+-o kms",ems + z <br /> (Home/Cabin; Commerlicial Business; Bedroom; Deck; etc.) o ° <br /> BUILDING CONTRACTOR: Sh terwL2fA L-w, n eI +— <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. p '� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) c <br /> 6 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. ti's, e <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW K <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). O <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 MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK o <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 DISTANCES o <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. r^\ o <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED, d v V <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE f <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> CU <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN W <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. z O <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. !; , <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <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 /> aoro <br /> 7. a `= R <br /> n� <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge 9 <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information p <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 accept all N o N N o b <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this appllcatlon. I agree to o t" <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- E [7 <br /> described premises at any reasonable time for the purpose of Inspection. c ?? y <br /> 5 r <br /> OWNER'S SIGNATURE <br /> (date) yq o a Ky <br /> ZONING ADMINISTRATOR 7 Cin (mn <br /> TOWNSHIP PERMITS MAY BE REQUIRED w o w ti <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE o U o <br />