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i <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 ice of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER TELEPHONE <br /> r-oz6 > -6y6-d �S6 <br /> MAILING ADDRESS 755 cJLC n•Z ,'� I �-rr Sao/�j <br /> �7G.•O{,'h3 Jr DtLE�/L�Ll Wy lIj\ <br /> PROPERTY ADDRESS IO i✓ / <br /> VOA er Wil _ 4� <br /> LEGAL DESCRIPTION ti 7— o16 — <br /> - 2- Ho- <br /> D - 13-$ • iS - >3o-v s,2000 <br /> rrvE of veglan(s): SINGLE-FAMILY DWELLING❑ ADDIITON DECK ❑ GARAGE/ACCESSORY STRUCTURE❑ _ r— <br /> BUNKHOUSE 0 59.692(IV)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 � <br /> _ I <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE❑ <br /> STRUCTURE/ADDITION USE: 3 � WeW [s'� V 1 rC. 4S_ c P <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) —t— • <br /> BUILDING CONTRACTOR: Wl � �C 13; 1/at�if3 �I7— L/,? LE�pj <br /> A PLOT PUN MUST BE PROVIDED ON AN 8 Vz X11 SHEET OF PAPER. ANY INCOMPLET R ILLEGIBLE PLOT PLANS r <br /> WILL BE RETURNED. <br /> n <br /> DIRECTIONS FOR PLOT PUN DRAWING: (ARIAL OR TOP VIEW) <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 r7 d S <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, J <br /> AND INDICATE NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S) SLI TO CENTERLINE OF ROAD,(C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK CilO <br /> (OHWM)OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND(D) LOT DIMENSIONS. (L 7 <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND ORAINFIELD(DF),AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. I <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PUNS ARE SUBMITTED By AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR,ETC.,THE / ^ <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. ( v ) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED 50 AN ONSITE VERIFICATION MY BE DONE WHEN I' <br /> NEEDED. <br /> L <br /> THIS PERMIT IS SUBJECT TO ALL CONDRIONS LISTED BELOW: <br /> " I C <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. = z C <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. W z <br /> 3. NO GRADING OR SHOREUND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <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. RJ <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> rn : + c - <br /> Ideclare that this application(including any accompanying <br /> cowled e)M1a t been examined e f r t and to Me best u my <br /> knowledge and beliefitishisa true,correctn(i and Complete. 1 acknowledge Nate ulresponsibleforthedetailand accuracy of all <br /> information contained in this application(including any accompanying uM1etlule)and ifur[M1er declare Mat[recognize that this <br /> information 1 am providing will be relied!upon by Me County of foment Wisconsin in determining whether to issue a Permit. 1 _ <br /> further accept all liabilitythat may be a result of Me County of Burnett relying an this informationlam providing in this <br /> application. Sagree to Permit county oTidals charged with administrating county ordinances or other authorized Person to cel <br /> have access to the abeve-described premises at any reasonable Cme for the purpose of inspection. i = <br /> OWNER'S SIGNATURE J '� <br /> (date) <br /> ZONING ADMINISTRATOR_ _ /2/=S-% _ _ x 7 _ <br /> / TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE a — <br />