Laserfiche WebLink
C rt <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g � <br /> APPLICATION FOR LAND USE PERMITS y <br /> OWNER iT TELEPHONE/ <br /> MAILING ADDRESS <br /> LG .C7G <br /> PROPERTY ADDRESS '61,55def 2 .�ss 4-c /4c /eYs �_1 C s)j C� <br /> LEGAL DESCRIPTION > / <br /> 60JC/�NtCN'r ^� Nw xy <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLIN ADDITION 0 DECK Cl GARAGE/ACCESSORY STRUCTURE ❑ / ^ <br /> BUNKHOUS5'$ 59.692(1V)GAZEBO El STAIRS ElFILLING/GRADING El CAMPING UNIT [I <br /> n <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ <br /> STRUCTURE/ADDITION USE: I/o z <br /> (Home Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> 0 <br /> BUILDING CONTRACTOR: '3-.,40JStt aa. , 1- n <br /> O � <br /> A WILL BE RETURNED.PLOT PLAN MUST BE PROVIDED ON AN 8 r/e X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C 0 <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 mV <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW m <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, a <br /> AND INDICATE NORTH (N). N Z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDINGS) °� ° <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK R. <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. p <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES q' <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. y <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 /> I <br /> NOTE: BUILDING/STRUCrURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATI <br /> NEEDED. ON MY BE DONE WHEN <br /> ^ <br /> THIS PERMIT IS SUBIECT TO ALL CONDITIONS LISTED BELOW: r... <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 6 <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 /> 6 NOT TO BE USED FOR HUMAN HABITATION. <br /> 7. ^ 7y > naOro <br /> [declare that this application(Including any accompanying schedule)has been examined by me and to the best of myc ° 9 9 9 S w <br /> knowledge and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all 2 d a! ! y <br /> Inforrnatlon contained In this application(Including any accompanying schedule)and I further declare that i recognize that this E.P <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a perrnit. I d S a <br /> application. I agrefurther accept all e Ioi ty permit county of c althat may be a resue charged with administratingof the County of Burnettying o my ordinancon this es oroz <br /> other author I amIn <br /> pe soin to have o r <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. ,5 �„ w <br /> tl S 9 000 0 0 0 y <br /> OWNER'S SIGNATURE S'G /3 A, <br /> (date) <br /> ZONING ADMINISTRAT R <br /> HIM <br /> IM <br /> � y <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N o N N o <br /> � � 00000 <br />