Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 ice of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS R <br /> OWNER `{e TELEPHONE `71S_ zqt,�I T MAILING ADDRESS "�"1q Ocl __ PR,-Jid 1 SN0".Y`t -]CTG I�PROPERTY ADDRESSG�Z73Z lucbc D ckLEGAL DESCRIPTION A Lok' 4 C.S TYPE OF PERMrr(S): SINGLE-FAMILY DWELLING fj7/ ADDITION 0 DE K 0 GARAGE/AC E SORY STRU URE 0 <br /> BUNKHOUSE 0 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 0 .b <br /> COMMERCIAL BUILDING 0 CO1MMERCIAL ADDITION 0 COMMERCIAL ACCESSORY STRUCTURE 0 <br /> STRUCTURE/ADDITION USE: ITS L 0a b 1 V1 pz <br /> W <br /> /(Hom /Cabin; Commercial Business; Bedroom; Deck; etc.)V <br /> BUILDING CONTRACTOR: W Af r- <br /> O <br /> � o <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. QJ 8 " <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) C I{-_ W, <br /> 1. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. "O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW C5 <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, 'b5 <br /> AND INDICATE NORTH (N). 6 qu o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) S' 1 P <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK p) <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. r rSki <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES _j, rn <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE Ui �) 91 <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> 3 i <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 LISPED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 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. I ,� <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/STORAGE ONLY. � <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7, aW > Prp G: a ro <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 it <br /> information contained in this application(including any accompanying schedule)and I further declare that I recognize that this E. 9 m N <br /> a a^ <br /> information I am providing will be relied upon by the County of Burnett Wisconsin In determining whether re issue a Permit. I <br /> further accept all liability that may be a result of the County of Burnett relying on this information I am providing in this <br /> application. i agree to permit county officials charged with administrating county ordinances or other authorized person to <br /> have access to the above-described premises at any rea��j)nable time for the purpose of Ins 6 FF) P P o g A n <br /> Oil <br /> OWNER'S SIGNATURE Y" e� Ie 8 <br /> ( are ve Y'? to h C7 Ei 2' <br /> ZONING ADMINISTRATOR MAY7 7 0 0 € <br /> H e � <br /> OWNSHIP PERMITS MAY BE REQUIRED BURNET'T COUNTY <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUA ►CO (^�I g , <br /> W N M88 M O <br /> t n vS 0 0 0 <br />