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—. <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator St C <br /> APPLICATION FOR LAND USE PERMITS `. <br /> 7 L. <br /> = n 1 <br /> OWNER ' 1 ' jrcy.-14—.‘ TELEPHONE . L <br /> E <br /> PROPERTY ADDRESS <br /> 3 6o Se_i,Jr4 Ly-, Of <br /> r <br /> 6 <br /> LEGAL DESCRIPTION / / S ,SYS. T vii g is <br /> :;r, -, L <br /> MAILING ADDRESSa. S /c y -2--- ._ <br /> TYPE OF PERMIT(S): V761 <br /> J Single Family Dwelling O Garage/Accessory Structure ❑ Stairs ❑ Commercial Building ' CA <br /> piAddition O Bunkhouse 0 Filling/Grading ❑ Commercial Addition <br /> 0 Deck ❑ 59.692(1v)Gazebo ❑ Camping Unit Cl Commercial Acc. Structure <br /> f } I l c - <br /> STRUCTURE/ADDITION USE: Eel//:).,*7 / atA lig 9 U.r'pA,y .r.."i ) z <br /> (Home/Cabin; CommerciBusiness; Bedroom; Deck; etc.) <br /> h � <br /> BUILDING CONTRACTOR: -84 <br /> = r j_4- v42 i. -2:* i <br /> -aJ' - •44.6 7 0 - E. i <br /> .2,?-2 .,7 ' 72 r7 <br /> ..n <br /> r _ <br /> PLOT PLAN ---INCOMPLETE OR ILLEGIBLE PLOT PLANS WILL BE RETURNED. z <br /> T g <br /> ***REQUIRED PLOT PLAN INFORMATION*** a <br /> © 81/2"X 11"SHEET OF PAPER DISTANCE(IN FEET)TO: �? <br /> N DRAWN TO SCALE OR DISTANCES LABELED W WELL <br /> tit PROPOSED BUILDING/STRUCTURE LOCATION al SEPTIC TANK&DRAINFIELD <br /> --)Dimensions&Heights ,El ROAD RIGHT-OF-WAY IF SURVEYED SO <br /> EXISTING BUILDINGS/STRUCTURES (Includes deck, porch, etc.) -)CENTERLINE IF NOT SURVEYED n <br /> - Dimensions&Heights ❑ ALL PROPERTY LINES <br /> •f. <br /> NORTH ARROW 6 ORDINARY HIGH WATER MARK <br /> ,BI ALL WETLAND AREAS l r "1 <br /> NOTE: Building/structure location must be staked for onsite venfication when needed, s Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ,.,•,, . r• Removal or cutting of trees and vegetation is restricted along shoreline !• No structures(including retaining walls,etc.)are allowed unless specifically permi i <br /> • No filling,grading,or shore land alterations are allowed unless specifically permittEEC°. <br /> SEP 30 2014 i <br /> • Driveway must meet width requirements within 60 days of permit w p- d <br /> + Accessory structure/garage permits allow for private residential storage only n {{{ <br /> **Not to be used for human habitation or rental storage`* BURNE//T��T{{CO( UNTY 2 z <br /> I declare that this application(including any accompanying schedule)has been examined by me and to tf `If�s'YNr1fy knowledge and @., <br /> I^ V <br /> --tent at!ctruc,cc:::C an::ca r.c:. :acknowledge that I an.I Cslwnsibie for die detail and accuracy—of ail information contained inl <br /> this application (including any accompanying schedule)and I further declare that I recognize that this information provided will be }1 <br /> relied upon by the County of Burnett Wisconsin in determining whether to issue a permit_ I further accept all liability that may be a <br /> result of the County of Burnett relying on this information I am providing in this application. I agree to permit county officials charged 1 <br /> with administrating county ordinances or other authorized persons to have access to the above-described premises at any reasonable <br /> time for the purpose of inspection. :� T > n ^ n C i " <br /> 7 r, n 'Z J O w L <br /> --ADDITIONAL CONDITIONS--- ( ' 7.. ?-. <br /> - ''• <br /> CONDITIONS--- ';' (An n 5 <br /> Se,ae.54T./v E g _.5--re,,,-Az-re <br /> 5Tb. l/c2�i �s, .- U/itn�' / fel /U7" /t/�.E 'S � 5U-- d E d •a <br /> IV we) MORE i7/ M'1 SOB, Of THE Srrc1crvAc. cdr,A IE1J7 �,1t( BE1 V v . <br /> 4 A-E17 DA PG/9cED. © REcoieD tonus ANDFz!oNS > <br /> 5/-/ & /I1or _XcE1� 35' h' IG%//T AZ-A4X7 f}FffJ pf,tdST R SEPTZG U 7 �, w N ; <br /> sysTt.� By 1i S1zoiy. a a >; -• x . <br /> ihre <br /> OWNER'S SIGNATURE Y�1•'�-t— 11 `� ! M r v — . <br /> (date) 5 =. 5- P. 2 <br /> ZONING OFFICIAL /0/2/1 ZOl y N <br /> �Ee c -0 <br /> (d ) fi C F <br /> **TOWN/UDC PERMITS MAY BE REQUIRED **THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE n = <br /> You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. . °' <br /> Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification ;,, ,, <br /> of construction that violates the law or other penalties or costs. For more information visit the Department of Natural Resources N- ^r s <br /> wetlands identification web page or contact a Department of Natural Resources service center. <br />