Laserfiche WebLink
C � O <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER ._ }i-� TELEPHONE <br /> MAILING ADDRESS <br /> 071��1 �pp� <br /> PROPERTY ADDRESS ) -O (_ <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING 0 ADDITION * DECK 0 GARAGE/ACCESSORY STRUCTURED y -� <br /> BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION 0 COgqMMERCIAL ACCESSORY STRUCTURE 0 r' <br /> A <br /> STRUCTURE/ADDITION USE: T-AO <br /> (Home/Cabin; Commer dal Business; Bedroom; Deck; etc.) SL <br /> (,Jp <br /> BUILDING CONTRACTOR: n <br /> T <br /> y <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/1X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C c _ <br /> WILL BE RETURNED. <br /> a � <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m p <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 m w '' o <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, a <br /> AND INDICATE NORTH (N). N o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDINGS)TO ALL LOT LINES, (B) BUILDINGS) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. p Up <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES t fy 1 <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE c <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. <br /> THIS PERMIT IS SUBIECI TO ALL CONDITIONS LISTED BELOW: r p <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. n <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER �N <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. f <br /> 6. <br /> 2 gy � nnn � ap � <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 0 <br /> knowledge and belief R 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 5.a 9 m <br /> Information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I a 5 no <br /> further acceptall liability that may be <br /> a result of the County of Burnett relying on this information I am providing In this c H in in: !n N b <br /> application. agree to permit county officials charged with administrating county ordinances or other authorized person to havec '2 c c o <br /> access to the above-described s at any reasonable time for the purpose of Inspection. d. <br /> n n o w N w <br /> OWNER'S SIGNATURE 1/ is n r^ d o = no .. _ Z <br /> (dated. <br /> ZONING ADMINISTRATOR <br /> R C �6 I•I <br /> y � . <br /> TOWNSHIP PERMITS MAY BE REQUIRED y <br /> TH PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> m gc4l� tD 6ra�-c /-Cro/( <br />