Laserfiche WebLink
� o <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator Qa U. <br /> APPLICATION FOR LAND USE PERMITS H <br /> a <br /> OWNER ,{ �oSG E. 1 TELEPHONE 5/_7-79-7# 1 e y <br /> MAILING ADDRESS � J JV LAD 1T�F' Ge A 12 L Pf 4t!£JAI � /oma <br /> 31C� L p1DAKS Ie 1aL7 on " SS//o } 3 <br /> PROPERTY ADDRESS illr „ C n�j � CT pAN � � c� C) O <br /> -T 1.1 J'r <br /> LEGAL DESCRIPTION LO j /_ i LIT JAGK.SO cJ <br /> TYPE OF PERMTf(S): SINGLE-FAMILY DWELLING ADDITION ❑ DECK GARAGE/ACCESSORY STRUCTURE ❑ <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> o <br /> COMMERCIAL BUILDING❑ COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o <br /> - r <br /> STRUCTURE/ADDITION USE: M o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) — UJ <br /> r� �I£ - �,�_lis-jfb3-�3aq <br /> BUILDING CONTRACTOR: y <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS O o N-t- <br /> WILL <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) M L� <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 M 3 <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, V� <br /> AND INDICATE NORTH (N). <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 6 <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS. t7 <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES N <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. �J <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. y <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. S <br /> NOTE: BUllDING/STRUCfURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. " 1 <br /> THIS PERMIT IS SUBIECr TO ALL CONDITIONS LISTED BELOW: G <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n Z O d <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. In <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. d <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 /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> � rt an nn L)> t�'f <br /> 7. <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my 0 0,°Z ^ 'RP 9 'w <br /> knowledge and belief R Is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of all m i== a <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this <br /> Information 1 am providing will be relled upon by the County of Burnett Wisconsin in determining whether to Issue a penntt. I <br /> further accept all liability that may be a result of the County of Burnett relying on this Inrormatlon 1 am proNding in this <br /> application. I=ta pertntt omtlals charged edminLatratlng county ordinances or other authorized Person to hove m 8 8 8 8 rri <br /> access to the above-desalbed,(G Ises at any reasonable time for the purpose of Inspection. <br /> °y w N o 8 <br /> � �� � <br /> OWNER'S SIGNATUR'c_T�"«��� (Y-Cl-dx. a a m n m =C <br /> �v, a�: � ��.=. z <br /> (date) � a� n �0 6 � <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 01 N Ngo 0 o e <br />