Laserfiche WebLink
Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS = _ a xxx111 <br /> a <br /> OWNER TELEPHONE <br /> O <br /> MAILING ADDRESS a� F <br /> o -k 5�d8a <br /> PROPERTY ADDRESS <br /> 86 <br /> I h e� /` h e �_ <br /> o � <br /> LEGAL DESCRIPTION <br /> c <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION DECK❑ GARAGE/ACCESSORY STRUCTURE ❑ b <br /> m <br /> BUNKHOUSE ❑ 59.692(1V)GAZESO ❑ STAIRS❑ FILLING/GRADING ❑ CAMPING UNIT❑ r- 3. <br /> 0 <br /> 0 <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE❑ k') <br /> _ (� <br /> STRUCTURE/ADDITION USE: -B&OW d L I UI 0r(YL-S fV r'I ` 1 <br /> (Home/Cabin;Commercialess a room - ; e; c c. <br /> n <br /> BUILDING CONTRACTOR: <br /> O <_ <br /> � c <br /> � c <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 t/z X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS_ U $ <br /> WILL BE RETURNED. C7 <br /> n Q� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) C <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 �, E. �, a <br /> BUILDINGS/STRUCTURES(NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, J m <br /> AND INDICATE NORTH(N). o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S) n <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. <br /> 4. 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 �- W <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. H <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN L <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Z <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. 'A G <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. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER J <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. G <br /> NOT TO BE USED FOR HUMAN HABITATION. G �' <br /> 6. <br /> � 'D o 0 o N a O b <br /> F <br /> 7. <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my c 5 y .moo y <br /> knowledge and belief R is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all d a n a T <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this 'ti <br /> s <br /> information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit I <br /> O X p y <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this o m y : 5� �d, <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorized person to have m 2 d+o,car o <br /> access to the above-described premises at any reasonable time for the purpose of inspection. D <br /> OWNER'S SIGNATURE n fD a? n cl ^! <br /> 0 <br /> (date) <br /> 21, <br /> ZONING ADMINISTRATOR J <br /> �1 ,(��.n C?" ? c a n til <br /> TOWNSHIP PERMITS MAY BE REQUIRED 6 ; <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> Perrn� 4 �e�+��p(c tipb� nnarv. ewez 10-Ia-11 U � � oo <br />