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Bumett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator H <br /> APPLICATION FOR LAND USE PERMITS a ' <br /> I <br /> OW ER4. <br /> �'F�11 LTro(/IGS TELEPHONE/ QC -7OQ o <br /> r S <br /> MAILING ADDRES /t <br /> X79 l'f�rrn � ra� A WnbS�u' t./; Sz1R9� < <br /> t <br /> PROPERTY ADDRESS a <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMIT(S): SINGLE FAMILY DWELLING ItGARAGE/ACCESSORY STRUCTURE ❑ ADDITIO ❑ STAIRS ❑ o <br /> FILLING/GRADING❑ CAMPING UNIT❑ BUNKHOUSE ❑ 59.692(IV)GAZEBO❑ DECK ❑ 7 7 <br /> STRUCTURE/ADDITION USE: mL <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) c <br /> BUILDING CONTRACTOR: C/S <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 Ya X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIB PLOT PLANS {h_ <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) `— <br /> 6 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. p <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW ^_ e <br /> BUILDINGS/STRUCTURES(Ift INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, `�.•• <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B 1 BUILDING(S) (� <br /> TO CENTERLINE OF ROAD, (C)BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK \ 3 <br /> (OHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),ANDA DISTANCES o <br /> TO BUILDINGS,ROADS, LAKE, LOT LINES. J <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR Fit LED. <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. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN ~ <br /> NEEDED. I <br /> THIS PERMIT IS SUB3ECT TO ALL CONDITIONS LISTED BELOW: <br /> I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. " x <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMED. g <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED ATE: <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE O, ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. E <br /> 6. <br /> 2. <br /> R;r€ to <br /> I dedarc tAa[This application(kidrrding arty accompanying schedule)has been examined by me and—tote best of y knowledge <br /> and belkf It is true,correct and template. I acknowledge that I am responsible for the detail and accuracy of all information ? ''- <br /> contained in this application(indWIng any accompanying schedule)and I further declare that I recognize that this information I z! R D <br /> am providing will be relied upon by the unty of Burnett Wisconsin M determining whether to Issue a permit. I fu er accept all <br /> liability that may be a result of the ty Burnett rtlyMg on this Information I am providing In this application. I agree to ; a �•s <br /> Permit county officials charged with min ting county o a other auftrired person to have access to above- 6 u r <br /> described promises;at any na for the pu of n. > <br /> OWNER'S SIGNATURE 17 <br /> Oate ^ � o > <br /> in <br /> ZONING ADMINISTRATOR A <br /> M <br /> TOWNSHIP PERMIY BE REQUIRED 3 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF JUANCOUL, <br /> 2 0% 2007 € N M <br /> BURNETT COUNTY <br /> ZONING <br />