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 PEIR'yMITS <br /> fJ <br /> TELEPHONE <br /> OWNER n <br /> r � �e4A4ddleen hefz <br /> G <br /> o <br /> MAILING ADDRESS <br /> 11 <br /> 62`( W_ k'V UrGWe,�yJ Lito' <br /> k R <br /> PROPERTY ADDRESS I�� { <br /> W ROnd lake <br /> LEGAL DESCRIPTION 0,�)I`Yl V. <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADD1ITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE � <br /> BUNKHOUSE 0 59.692(1V)GAZEBO O STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 Z 4- <br /> COMMERCIAL BUILDING El ,fCIOM�MERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 <br /> Gd- <br /> 0 � � <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; C&Mmercial Business; Bedroom; Deck; etc.) (� <br /> BUILDING CONTRACTOR: n GI <br /> 3 <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Vz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o <br /> WILL BE RETURNED. <br /> o <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 (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, 9 <br /> AND INDICATE NORTH(N). N Z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) $ 6 ° <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. p v <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. r„ 0' I <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 QJ E <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> i <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. Al <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: IJ vU <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WCfHIN 60 DAYS OF PERMIT. ,z O <br /> n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. a <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER H <br /> SETBACK AREA. I --� <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. F <br /> 7. >000pnpapro <br /> R n o333IS E,� tz1 <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my y o <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all rp S' d rn <br /> information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this D a m <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I <br /> further accept all liability that may be a result of the County of Burnett relying on this information 1 am providing In this c "' �,i»�.`- H N V <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. > $c c 8 <br /> OWNER'S SIGNATURE <br /> rya= WmpH„ O <br /> (date) A Z <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED g ( ' <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE N«»»`- <br /> �erm� ���e-�-�e✓� m���� goo . $ <br />