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Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator - <br /> APPLICATION FOR LAND USE PERMITS L <br /> I <br /> OWNER ' / TELEPHONE -qft bArijH, f JEAA/AIIE kfAA/ fCIl 7/,5-69q—�50MAILING ADDRESS <br /> ton i-1(uy 1.3 54LL)ulm/I W'T 59002PROPERTY ADDRESS ,. n� ; <br /> zbc <br /> 70 /h }FE <br /> T/Al LAAf [IpA/ti (01 5 /S0/ �L�I <br /> LEGAL DESCRIPTION 511 A-r T.4cHFb <br /> TYPE OF PERMIT(B): SINGLE-FAMILY DWELLING 0 ADDITION M DECK 0 GARAGE/ACCESSORY STRUCTURE E <br /> BUNKHOUSE 0 59.692(IV)GAZEBO 0 STAIRS 0 FILLING/GRADING I7 CAMPING UNIT❑ ' <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE E <br /> STRUCTURE/ADDMON USE: H 0 mf = z <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: SELF O <br /> n <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yx%11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PIANS 'I S <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE C <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES(NS), 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) c <br /> TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. o <br /> 9. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. - <br /> S. 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 L <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN W <br /> NEEDED. / <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1 <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. — m <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 9. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SEFBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. I L <br /> NOT TO BE USED FOR HUMAN HABITATION. r <br /> 6. <br /> 7. F > _ r n > c r <br /> R 4 F 3 a s <br /> . A <br /> 1 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 l am responsible tar Me detail and accumcy of all <br /> information contained in this application(including any accompanying schedule)and l further declare that l recognize that this _ > ao.F ,p, ; <br /> information I am providing will be relied upon by the county of Burnett Wisconsin in determining whether to Issue a permit 1 �' i <br /> further accept all liability that may be a result of Me County of Burnett relying on this information I am providing in this _ a': 'q `^ '0 <br /> application. I agree to Permit county officials charged with administrating county ordinances or other authorized person to <br /> have access to Me abov rmedpre ises at any reasonable time tar Me purpose of inspei v > N ylry <br /> OWNER'S SIGNATURE OZ <br /> 3 — <br /> ante) 1J Nnoo LON f58> w d e <br /> ZONING ADMINISTRATOR 3.'i_g ^ : <br /> 1 41OZ61AV, ,. Faro <br /> TOWNSHIP PERMITS MAY BE REQUIRED a (1 :" <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUI,NGE�. I ' (l <br /> �"AR Fn <br />