Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS a a� <br /> OWNER �(���.� LUP/lam TELEPHONEjq/ <br /> � - F " J( �/ -� <br /> �"� TT w � <br /> MAILING ADDRESS //0 /-/N E' R)D baa R?L*oZ �L(l141 5�e1 O <br /> Q T o <br /> PROPERTY ADDRESS / Zo CSU S/l/..ol-c 1 <br /> LEGAL DESCRIPTION S/ 7 rqo A 9 /LAQ 40T Z 6Sl':7 VJ7 p, <br /> SINGLE FAMILY DWELLING 0 GARAGE/ACCESSORY STRUCTUREV ADDITION 0 STAIRS ❑ o <br /> TYPE OF PERMrr(S): 9 <br /> FILLING/GRADDIINNGLI CAMPING UNIT 0 BUNKHOUSE 0 59.692(1V)GAZEBO 0 DECK 0 <br /> STRUCTURE/ADDITION USE: 6F 146-D 'Z _ <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) o ° <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C <br /> WILL BE RETURNED. 4 <br /> O ° <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. IIL1\ O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW } B <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) BUILDINGS) (� o <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK O v <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. N ur <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD (DF),AND ALL DISTANCES 0. <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. C o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE n�b <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. F, C;lq <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN N n <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> r ` <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. zy <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <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. w <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. C <br /> NOT TO JBE USED FOR HUMAN HAB�TATION._//�� E <br /> 6. �d wlII `{Dl avri7yf/Lf /D{ /it 7yanmoa �Oro <br /> � � X37 Fam ts1 <br /> 7. <br /> ONO "0 <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Information I ,� c <br /> m providing will be relled upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accept all <br /> liability that may be a result of the County of Burnett relying on this Information I am providing in this application. I agree to <br /> a <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- <br /> described premises at any reasonable time for the purpose of Inspe o 7 <br /> OWNER'S SIGNATURE <br /> m : <br /> (date)'. az ? P o>y L� Ky <br /> ZONING ADMINISTRATOR �� I` Llit.✓l/"Iah '� <br /> ffi o . <br /> < o <br /> e <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE Gw <br /> rrV,�=le Dl ic� Kev�� 131� �)w 4�l -09 <br />