Laserfiche WebLink
y O <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 office of Zoning Administrator g � <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER C JOhY a)n TELEPHONE rou� 651 - gq8-oj(05 0 <br /> MAILING ADDRESS Fire 0 LCt.4 elmo m lo 5604 <br /> kDJ PROPERTY ADDRESS rI LP W `1-eilbu otr, � Day&�nAof nY 1 , " L <br /> LEGAL DESCRIPTION F L4 0 (Z R, Pe.L � 4b. 16. 169. o (a 00 9, <br /> TYPE OF PERMMS): SINGLE-FAMILY DWELLING ❑ ADDITIOfK DECK ❑ GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ — <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> ON USE: 5' 3 <br /> STRUCTURE/ADDITIE: 1 QC xLeCf ;j1 i & <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) ^ <br /> by k?ver � dch Sao- -1113 <br /> BUILDING CONTRACTOR: A <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yt X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O o <br /> WILL BE RETURNED. <br /> n a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) O <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 w 3 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, O 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) G $ <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK G� <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. I O <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD (DF), AND ALL DISTANCES '° 1 <br /> TO 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 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ,I ...1 <br /> NEEDED. U111 <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: Y} �' d <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. () Z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. E A <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. U <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. " eir <br /> o n <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my B o ,:1 R_ °_ 2 <br /> knowledge and beliefIt 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 .o E. i� > m N y <br /> Information I am providing will be railed upon by the County of Burnett Wisconsin in determining whether to Issue a permit I w 2 '� <br /> further accept all Babtilty 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 ether authorized person to have <br /> access to the above-described promises at any reasonable time for the purpose of Inspection. ej <br /> R g g o g 8 y <br /> OWNERS SIGNATURE (date) <br /> ZONING <br /> �i •� ^ m P "�' x <br /> ZONING ADMINISTRATOR <br /> _^ _^^ TOWNSHIP PERMITS MAY BE REQUIRED <br />