Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator /.' <br /> APPLICATION FOR LAND USE PERMITS / 668b Ill "ft <br /> OWNER /< O1,1 y P,( �� l y� TELEPHONE S� l(JI1� (� tot I <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS �71J 1 I Q�� e �al` r Qd , 1�a1l ,JU�Tf = <br /> LEGAL DESCRIPTION �-((- '>0 I� TIT y Q i I 1 ., 1I 1 TOWLsJ 1'Y OLY IG <br /> lY �'V yU acres <br /> TYPEOFPERMTT(S): SINGLE-FAMILY DWELLING ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE ❑ e <br /> BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FRLING/GRADING 0 CAMPING UNIT 0 <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION Cl COMMERCIAL ACCESSORY STRUCTURE ❑ _ <br /> STRUCTURE/ADDITION USE: CO.b) I'1 .301G3Sf , <br /> .(Nome/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: \� p P ?C C I� m <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'a x X1I SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS _ <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. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW tt — <br /> BUILDINGS/STRUCTURES (NE), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, o <br /> AND INDICATE NORTH (N). p i <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) SUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK16 <br /> (OHWM)OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND(D) LOT DIMENSIONS. VQLi <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND GRAINFIELD (DF), AND ALL DISTANCES I <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 r <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. 4-- - TT_BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN �� ) _ I ' <br /> NEEDED. CD <br /> I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT.2. REMOVAL REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. z <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. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 7. z >it 2 <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. 1 acknowledge that 1 am responsible for the detail and accuracy of all InInformation contained In this application(including any accompanying schedule)and I further declare that 1 recognize that this Y '. rs� <br /> I"miatlon I am providing wlll be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. 1 <br /> further accept all liability that may be a result of the County of a ttelying,on.this' fo ation i am providing in this c., <br /> application 1 agree to perm t county of is als charged w to bor stJat q coc tl' a or otner author zed person to have �,� o <br /> access to the above descrl mises at time f the Pup fMspicdon D /� d c <br /> OWNER'S SIGNATURE <br /> SE�aE)3 2013Mf - <br /> ZONING ADMINISTRATOR <br /> /3P BURNETT COUNTY <br /> TOWNSHIP PERMITS MAY BE REQUIRE �ONING r <br /> THIS,PE SHALL E� PIRE ONE YEAR FROM DATE OF ISSUANC <br /> /\I -+ <br /> yv0 iiaJOlc,�. _ _ 4 - <br /> d <br /> 0 <br />