Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> 0 <br /> 7 <br /> OWNER �� �r' �� �{//SO!/I TELEPHONE /�-� ���-��(� / o <br /> MAILING ADDRESS I <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMITS): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE v: <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITION USE: G <br /> (Home/Cabin; Co me/rrccial Business; Bedroom; Deck; etc.) N <br /> BUILDING CONTRACTOR: 5/e4mi,j 'J VI" <br /> I r '/�c <br /> s T T <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. r cu <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 NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, -� <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK 5- rte, <br /> ro <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. O i� <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES ^ ` <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. C,i <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. !^ z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. GJ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. C!I C= <br /> NOT TO BE USED FOR HUMAN HABITATION. A <br /> 6. 111u,�� � m?r� . L4 {-�'v✓h F�a6jr e+^c( _5c, frtivh iIJ'I'l <br /> ? > oo <br /> H 6 ry <br /> 7. rZ '„^ 7 dao o <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 o. m F r F a <br /> information contained In this application(Including any accompanying schedule)and I further declare that 1 recognize that this `- > > <br /> a lag cd_ . Y <br /> information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Issue a permit. I �. � _ r, 4,ro : -C <br /> further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have <br /> access to the above-described premises at any r asonable time-for ase of inspection. ' y <br /> _. ro <br /> OWNER'S SIGNATURE (date) <br /> �J6f1 F� C{✓llC <br /> ZONING ADMINISTRATOR <br /> c to <br /> TOWNSHIP PERMITS MAY BE REQUIRED I <br /> m <br /> THIS PERMIT 1SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE Z � <br /> ���Y/Y1t I � v 1 1f✓ VG6 (e,,l LoTi/6;L/ I�<C�s �n NaS � �00000 <br />