Laserfiche WebLink
Z <br /> 3 <br /> Burnett County 7410 County Road K,No. 102, Siren,WI 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS = <br /> OWNER j�ry /-� �2e / /_^ -�- TELEPHONE I7,IryG� , 900 - 191 p (� •I o <br /> MAILING ADDRESS �. V/� y 3 r C� IIIIL✓[L�e� 11/IJ'u 1755OYd-195/p <br /> ir <br /> PROPERTY ADDRESS S3 R C <br /> C( 7 <br /> LEGALDESCRIPRON I � I nyr I /VI ���,� I ( 1p jT&Gj _ <br /> rrvE OF PERMITS): SINGLE-FAMILY WELLING ADDITION ❑ DECK GARAGE/ACCESSORY STRUCTURE❑ _ <br /> BUNKHOUSE❑ 59.692(1V)GAZEBO 0 SFAIRS ❑ FILLING/GRADING❑ CAMPING UNIT 0 IF_S <br /> COMMERCIAL BUILDING❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE 0 IR <br /> c / / z <br /> STRURURE/ADDITiON USE: Ulf <7lGYsa,IU G`/(H� <br /> (Hom/e/Cabin omm <br /> flercial Buvness; room; Deck;etc.) I (0 <br /> BUILDING CONTRACTOR: <br /> LJ ru-Ce bi /I,CYh/C. '% <br /> z <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Vz XII SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. r J <br /> n <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) q <br /> L ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL E ISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH(N). � -0 z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S) Q <br /> TO CENTERLINE OF ROAD,(C) BUILDING MEASUREMENTS)TO THE ORDINARY HIGH WATER MARK ,J o C <br /> (OHWM)OF CAKE,STRUM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. �U 9 <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES Lry _? C <br /> TO BUILDINGS, ROADS, CAKE, LOT LINES. ` h <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. S i� s <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE <br /> PUNS MUST BE SIGNED AND DATED BY THE OWNER. O F <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: - C. <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. _- <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. f <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. b <br /> 4. NO STRUCTURES,INCLUDING RETAINING WAL15, 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 /> 6. <br /> 7. <br /> me and <br /> knowleeMat Misapplira[trueon,Frred gany acplete. acknowledges <br /> chedule)has <br /> et been exaresponsined ble <br /> for <br /> thedtailandabest ofmy _ - <br /> inormatioand <br /> ontainefitistisaplicatin(iand cludingayaccom,,atlge Mattam)andI urt for thedetailthat <br /> Irecognize of all _ <br /> information I am protlding al bas relied upon <br /> by the <br /> county of an me Wisdandin in determining <br /> hetert recognize that His 3 —_ <br /> information t am providing t will a te,a upon f Me County of Burnett Wisconsin in Determining wampro i issue a permit t _ <br /> furteeracception. I gnesll eiliry that mayeearesult s of rg County of Burned ingcrelying on thisinformationrother utoyitling in thisapplication. sagrm[o permit county officials charged with administrating county ordinances or other au[M1orizetl personM — 3 <br /> p or <br /> M1aveaaess to Meaeove-0 HDetl premises at any reasonable for Me purpose of inspection. <br /> OWNER'S SIGNATURE ? _ <br /> (nate) j <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED _ <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />