Laserfiche WebLink
w '11 Z <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator 5 <br /> APPLICATION FOR LAND USE PERMITS _ <br /> a — <br /> OWNER � S TELEPHONE <br /> MAILING ADDRESS <br /> 5 D l 1 v5\ C� <br /> PROPERTY ADDRESS �/ j <br /> �c� <br /> LEGAL DESCRIPTION L G-t l !O U/ /I I , /6(,- <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DEC ❑ G GE/ACCESSORY STRUCTURE t. 7t <br /> BUNKHOUSE❑ 59.692(1V)GAZEBO❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL AD ON ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> R Z <br /> STRUCTURE/ADDITION USE: D�-e L �- <br /> ome a m; Ommeraa usmess; room";U c ;etc.) <br /> BUILDING CONTRACTOR: �\.tiW\ \ C2.h C7✓v 0_' y N <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 rh X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS _ F <br /> WILL BE RETURNED. <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) C ,. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. av :° <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW O o <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, TT a <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) O I ° <br /> TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK O CX G <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. <br /> S� <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES QO n. <br /> TO BUILDINGS,ROADS, LAKE,LOT LINES. I i <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. � '-I r <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. N oo <br /> CA <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN C� y <br /> NEEDED. <br /> THIS PERMIT IS SU87ECT TO ALL CONDITIONS LISTED BELOW: <br /> G <br /> 1.. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. O p Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. I <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER Q -� <br /> SETBACK AREA. p, <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. g <br /> NOT TO BE USED FOR HUMAN HABITATION. p <br /> 6. C <br /> 7, 7J 9 r1 r'f r7 C7 9 0 ro <br /> Fn ` 333 go =. � <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my <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 relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I E c 'n = ; a <br /> further accept all liability that may a un of the County of Burnett relying on this information I am providing in this g i v,.`� "'N b <br /> application. I agree to permit co ials charged with administrating county ordinances or other out orized p n to Q c "' : g <br /> have access to the abo,, escnb mises at ny reasonable time"the purpose of Inspection. o D : g d,v."2 n <br /> W <br /> OWNER'S SIGNATURE 'S O A 8 g g .71 <br /> 0 <br /> a : � dQd =. z <br /> ZONING ADMINISTRATOR i x a w' rsy <br /> N w u v C�s1 <br /> OWNSHIP PERMITS MAY BE REQUIRED <br /> 2 O: <br /> THIS PERM SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE g <br /> CA <br /> coo8000 <br />