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Burrett Country 7410 County Road k No.102, Siren,WI 54872 Office of Zoning Administrator g C <br /> 11 <br /> APPLICATION FOR LAND USE PERMITS <br /> � <br /> OWNER CQ I S ^a TELPH <br /> EONEI7,_2 <br /> "A"' 3714 <br /> ROPERTYADDRESS3I1 U !J 0(' RF,n Llor ✓v <br /> LEGAL DESCRIPTION <br /> HAILING ADDRESS <br /> TYPE OF PERMTT(s): o <br /> ❑S gle Family Duelling XGaragefACCesswy Strubtre ❑Stairs Cl Cmm endal Building <br /> ❑Addition ❑Bunkhouse ❑ Filling/Grading ❑Comrne,cial Addition <br /> ❑ Deck ❑ 59.692(ly)Gazebo ❑Camping Unit ❑Cgmmecal AM.StRKture ' <br /> R <br /> SmUCI11RF/ADpIRON USE: n rZ <br /> (HprreJhpia;Cmynerdal Biaklas;lkdroom:Oelk;el[.) O <br /> BUILDING CONTRA(](OR: C� IP v <br /> 0 <br /> r � <br /> PLOT PLAN...INCOMPLETE OR ILLEGIBLE PLOT PLANS Mau BE RETURNED. z <br /> GIS <br /> ..*REQUIRED PLOT PLAN INFORMATION... 8. <br /> ❑ BVI•X 11'SHEET OF PAPER DISTANCE(IN FEET)T0: O 5L) <br /> ❑ DRAWN TO SCALE OR DISTANCES LABELED ❑ WELL <br /> ❑ PROPOSED BUILDING/STRUCTURE LOCATION ❑ SEPTIC TANK&DRAINFIELD <br /> iDimensions&Heights ❑ ROAD RIGHT-0F-WAY IF SURVEYED o <br /> ❑ EXISTING BLIILDINGS/STRUCTURES(Incudes deck,parch,etc.) -)CENTERUME IF NOT SURVEYED k <br /> 4Dimersiuns&Heights ❑ ALL PROPERTY LINES o n <br /> ❑ NORTH ARROW ❑ ORDINARY HIGH WATER MARK 9. <br /> ❑ ALL WETLAND AREAS ,..1 <br /> NOTE: Bultling/stncnee kration mist be staked for onsite vaifiodon when needed. 21/1ti n r, y <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: D I r 11 I�F1 /—I -9) <br /> • Raroval u n(incl d Nee andgVegetation Ils, )am al ed abng shale r lb VVV LS U L� I' 'I _ —. 11 <br /> • No mumaes(including or sh r e king wall,em.)are agowai Wes spaiNmq U <br /> • NONllnymustg,orshore tuCm auN khin60diam e a sspetlliragy AUG 15 214 <br /> • Dmesar must nett wl�drag .alt its ao witlin va days d penny A <br /> • <br /> Accessary strumue/gara¢permits alkav for privane resitleitlal storage only <br /> "Not to be used(or human habitation or rental storage• BURNETT COUNTY m <br /> C L <br /> I dadm mat tlia appl tin(kKm m rwa®.wrHoe virNWe)ten been mm4ree a me and m ane hy,_Jr,l <br /> btliel ltb We,mM atl� taArerWln malm r�ormlH ror medamn a,e+mwawatll keonvadon m.rtahrN Ar <br /> Nis aper n bn Cndneuq amumed rnp a in dita ant I nrurn sedan Duh I ria tort tab IdwmaNew Pwre,d wia W..alae neon by On.anon[,d aurru rrb�wu.b a.bruudnR wrrur,m brw,prnit. L Nvehs acupt,n lbGliry tax nun en a <br /> reset of m.eeru4 m Bu.ro urylrq on arb:rronruBen t m preeNhp m urb appnlratlon I aipae m pvmamwty otrrdar.drrP d E <br /> wim a impr ftUm adng mm ,oreirtrNo a Durr aumwiaea puvu m have yam m Ura aGewde>mTatl prrwmdta a[+nrl'ramuMa <br /> dens ma pupme edion <br /> g�gogo�S� <br /> —ADDITIONAL CDIDIDON r 3 g 3 I e <br /> L <br /> Q A// s�fdar �s 14 U 5 de ins 4 , � �'�_ <br /> LH <br /> OWNER'S SIGNATURE <br /> ZONING OFFICIAL J/^""'�— 27 Zeq/ p end"F a' <br /> ••TOWN/UDC PERMITS MAY BE ( ) —: a <br /> REQUIRED doral l S coraco SHALL EXPIRE OME TEAR wetlands, <br /> DATE OF ISSUANCE <br /> Wet a d.met a bL'mf sodate complying with <br /> en w did an be <br /> hau W low*Gp6ml to c ply M y r su ft In m bke5, modification sNJ <br /> Wetlands to are not dates the la h porn water ran be ,000S m denote. nform to mmply mar rest[ a.most a lltees H <br /> d mrsmrdon that viweba the law or ct a peretia or res Far rtiore OsontDNon v'si the Deyartlned d NaNral Reswars 'U'J:. <br /> wetlaMs itlentllkaWn web page or mdaR a OeParNrcl[d NaNrdl Re!auna servi¢mtv. `^8 b"`d'0 8 <br />