Laserfiche WebLink
/ n z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a V 1 y 1 <br /> APPLICATION FORA ND USE PERMITS <br /> OWNER r. A � z.!GR/f✓ TELEPHONE ��s <br /> � ,/ L <br /> MAILING ADDRESS <br /> PROPERTY ADDRESSGj ?v .,A�� <br /> ����ticL /� n 1 <br /> o 17, Q <br /> LEGAL DESCRIPTION 6 <br /> TYPE OF PERMITS): SINGLE-FAMILY DWELLING ❑ ADDITION ❑ DECK ❑ GARAGE/ACCESSORY STRUCTURE v <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO C1 STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION CI COMMERCIAL ACCESSORY STRUCTURE ❑ 2 <br /> STRUCTURE/ADDITION USE: r J^ 4 o <br /> (Home/Cabin; Ogjmmeldal Business; Bed ro ; Deck; etc.) a <br /> BUILDING CONTRACTOR: .��-,•� n <br /> � y <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 'h X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS o_ <br /> WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> /I. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> ,'. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB)AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). N, <br /> SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. ,� O r <br /> �l SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES , <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. v: <br /> INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. '1 <br /> �. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. \ <br /> 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. 90 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r- <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> S. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/ST RAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> a. Si rli T� be. A+ A4o - W'Ffi Fron f � <br /> 7. a D o 0 o Q a 0 '0 <br /> � 3 <br /> N 2- <br /> " `^ 3 3 0 ° <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my <br /> knowledge and belief It is true,correct and complete. I acknowledge that i am responsible for the detail and accuracy of all <br /> Information contained In this application(Including any accompanying schedule)and I further dedare that I recognize that this E, D D m N <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to issue a permit. I o a <br /> further accept all liability that may be a result of the County of Bum relying on this information I am providing In this <br /> application, I agree to permit county ofFld rged with adm tr ng county ordinances or other authorized person to have ,-�, �� o 'o' c o r <br /> access to the above-described premis an easonabie t1 for a purpose of inspection. ¢ G o w <br /> _ l 3 'e1 y � co or <br /> OWNER'S SIGNATURE /v <br /> Asn 6 mEi mO <br /> � a sz <br /> ZONING ADMINISTRATOR y f,f, ' F . _ <br /> lul <br /> . gym <br /> TOWNSHIP PERMITS MAY BE REQUIRED ��� 15200 <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF I o N a U o <br /> COON <br /> BURNjoN%NG <br />