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Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator _ o 0 <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> m <br /> CD <br /> OWNER �1 YY1 �O r( �� TELEPHONE -16 3 Soa-OiW C <br /> m <br /> MAILING ADDRESS 9 Ky 1916 rro C!tf Rlaire Pti rj 55Y-1q v r <br /> l l <br /> PROPERTYADDRESS 'aq 755 C_jQ(y) II l& (A <br /> LEGAL DESCRIPTION(see tax receipt) f Cpidn a- CD <br /> cn <br /> _a <br /> TYPE OF PERMIT(S): <br /> DWELLING/BUILDING 1:1 GARAGE/ACCESS4Y STRAkTURE V ADDITION 1:1to <br /> v0 <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ \/STRUCTURE/ADDITION USE: r 2 ro, Qe, X Y 0 <br /> ome/Cabin; Commercial Business; Bedroom; Deck;etc.) co (�7 <br /> � `IY <br /> BUILDING CONTRACTOR: ck) 1 V1Q <br /> M <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O 3 <br /> � N ^ � <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> Do <br /> m �. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m T <br /> NORTH(N). C <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS, ROADS, LAKE, LOT LINES. <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., THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> q <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICA y��, t� a o c <br /> NEEDED./ 2 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. j 1% �S V o <br /> CONDITIONS OF PERMIT: pp �� ? 4 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PEReMWjr7NE�7-r / ^ I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. O�N <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY y <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER I <br /> SETBACK AREA. <br /> 5. C A� -fo ba - ��Q�> /� <br /> 6. S-trt (T U•..'? /wt '�' LlibP/� 'fYLI�A'tCi.. 2 r 20 O 5t o -0m <br /> w� � 'am yam � <br /> This structure to be used as private residential � ( C y W o 3 <br /> 7. garage/storage only. Not to be used for human o " T <br /> I declare that this application (including any accompanl habitation. n = N p <br /> _ y Lj i E <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of C <br /> M d, <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m I o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m O <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am m <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other <br /> authorized pers n to have access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> CD <br /> CD <br /> SIGN HERE r6o� .2 <br /> er <br /> sig atu f o er or building contracto (date � ) n <br /> 1 r" <br /> ZONING ADMINISTRATOR <br /> (� to to <br /> �y <br /> Nf)EA f Nj Efl 0 N <br /> CTNOO <br /> (lO N fT O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />