Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator z <br /> APPLICATION FOR LAND USE PERMITS a 3. <br /> OWNER R�3C(�raE � TELEPHONE ' <br /> tv � O <br /> MAILINGADDRESS �O�3y4X�L(< �f...� 5J �q/✓¢ KIw/ S�S4/D <br /> O <br /> PROPERTY ADDRESS SS&� j,�t/NifPrN�l L,acTLE Di2/d� <br /> LEGAL DESCRIPTION C1 y � <br /> /T <br /> DWELLING/BUILDING 0 GARAGE/ACCESSORY STRUCTURE 0 ADDITION 0 STAIRS ❑ °r. Y}1� <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING�10 CAMPING UNIT 0 BUNKHOUSE Cl 59.692(1V)GAZEBO 0 DECK 0 '3 -r- <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) o <br /> BUILDING CONTRACTOR: SGooc s�o�2r Ca✓Sn�ircrra..! <br /> J � <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS +� <br /> WILL BE RETURNED. F _ <br /> o_ <br /> DIRECTIONS FOR PLOT PLAN DRAWINi ..�` <br /> 1. ALL REQUIRED DIMENSIONS O k ' I _ en•+ <br /> 2. SHOW THE LOCATION AND 5: •0 ALL NEW <br /> BUILDINGS/STRUCTURES (NE ' tES, m <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET + ' - - ES, (5) BUILDINGS) c <br /> TO CENTERLINE OF ROAD, (C '"• � / /� WATER MARK <br /> (OHWM) OF LAKE, STREAM 0 /'/vim LCL NS. t� v, <br /> 4. SHOW THE LOCATION OF THI NON,eo�� 7) A WD ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE �/f� C - w' <br /> 5. INDICATE IF A WALKOUT BAI S�/J r` -' /v —llvvJJ OR FILLED. N (� <br /> 6. 1F SEPARATE PLANS ARE SUE RACTOR, ETC.,THE - <br /> PLANS MUST BE SIGNED ANC <br /> NOTE: NG/STRUCTURE LOCA ^ / I/ r MY BE DONE WHEN <br /> NEEDED. <br /> '(/„!�L ._�vw a✓3°_t(/ <br /> THIS PERMIT IS SUBJECT TO ALL COD <br /> z i <br /> 1. DRIVEWAY MUST MEET . <br /> 2. REMOVAL OR CUTTING OFF Tf TF � ��. INEINE. <br /> 3. NO GRADING OR SHORELANL .._._._..__.._ ...__ . _ - ERMITTED. 8 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER GJ <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. E <br /> 6. <br /> anmo> — � <br /> � � �R � BFcn <br /> 7. <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowledge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information <br /> contained in this application(Including any accompanying schedule)and I further declare that I recognize that this Information I _ <br /> am providing will be relied upon by the County of Burnett Wisconsin in determining whether to issue a permit. I further accept all �, ' <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree to _ n 8 "'`" 8 l- <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- <br /> described premises at any reasonable time for the purpose of Inspection. // // 7 <br /> OWNER'S SIGNATURE o � <br /> (date) ^ ` " o > E= <br /> e ry c w ts1 <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 8 o <br />