Laserfiche WebLink
c n Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS H <br /> OWNER <br /> TELEPHONE psi-as3-6'ss3 p <br /> MAILING ADDRESS <br /> PROPERTY ADDRESS Kcnll6c� 06Z_ Tlk( li, 1`' IF'\VI SOI <br /> C) � <br /> LEGAL DESCRIPTION C �� 7-40 <br /> ,d / <br /> TYPE OF PERMrr(S): SINGLE--FAMILY DWELLING 0 ADDITION D DECK 0 GARAGE/ACCESSORY STRUCTURE w <br /> BUNKHOUSE 0 59.692(1V)GAZEBO O STAIRS O FILLING/GRADING 0 CAMPING UNIT O <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURED 0 9 <br /> STRUCTURE/ADDITION USE: tui�C1��'O/`�Ji 'Z r <br /> (Home/Cabin; Commercial usiness; Bedroom; D ck; etc.)�-"-� rp(5_N/Ie _ 0435 "— p <br /> BUILDING CONTRACTOR: <br /> w <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'h O X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS Co <br /> WILL BE RETURNED. „I <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m <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 (NE), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, �' v 9 3 <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDING(S) O <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w' C) <br /> 4. SHOW THE LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. <br /> LOCATION OF THE WELL(W)SEPTIC TANK(ST)AND DRAINFIELD (D) <br /> HOWHEAND ALL DISTANCES SL) <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. 100 <br /> = ti <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 /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN C/l <br /> NEEDED. `� <br /> 6 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: QQI G (N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. U) n Z w <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. ` A <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. C <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. r <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. \ <br /> NOT TOB USED FOR HUMAN HABITATION. ,/_, 1 / <br /> 6. �'�Y'ttC, �.c -� he USac3 1—or 5%joXup <br /> 7. 9 1/ ^ gya� n�pnp; aoro <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my o n ^ 'w <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all a m iv,w' rn y <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this .o E.a a a <br /> 6A dG^ ; <br /> information ac I am providing will a relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I .`b 3 y p w S ,q <br /> further accept all liability that may be a result of the County of Burnett relying on this Information I am providing In this Q ��. b,e, <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 reasonable time for the purpose of inspection. Sto <br /> c o woo a <br /> ao 0 0 0 0 > <br /> OWNER'S SIGNATURE TC) /8 ) to m °' <br /> a a ,,,„ p <br /> n <br /> (date) a o x 3 E - Z <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS P MIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N <br /> �'��-��l�� �� fo arc,✓Cdf-Islr�.c � �� <br />