Laserfiche WebLink
C � Z <br /> Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator g 3 <br /> APPLICATION FOR LAND USE PERMITS N. y <br /> E <br /> OWNER /fit_ _ (.. it IIQA3G TELEPHONE <br /> C./W-5-W— y676 <br /> MAILING ADDRESS '/p7g we <br /> `STM Z�AuF�=�f ��Q'C�� <br /> PROPERTY ADDRESS <br /> '7gg <br /> LEGAL DESCRIPTION <br /> (/10v . CO4- 3 r4Q n/-1? 15- <br /> J <br /> TYPE OF PERMIT(S): SINGLE-FFAMILY DWELLING ADDITION ❑ DECK O GARAGE/ACCESSORY STRUCTURE ❑ l *1 <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT ❑ <br /> v <br /> COMMERCIAL BUILDING ❑ COM,,M//ERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE ❑ o � <br /> STRUCTURE/ADDITION USE: IYD"K- o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) �Q�p <br /> BUILDING CONTRACTOR: ' QUI <br /> O <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1Pe X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS C o S• <br /> WILL BE RETURNED. �J <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE, O"n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW m S o <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, Cy <br /> AND INDICATE NORTH (N). V N I z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING($)TO ALL LOT LINES, (B) BUILDING(S) O ° P <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK $J <br /> (OHWM) OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. p I <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK (ST)AND DRAINFIELD (DF),AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. w <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 o <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. UI <br /> O <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED, <br /> THIS PERMIT IS SUB]ECi TO ALL CONDITIONS LISTED BELOW: v l r ( <br /> pI � <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. E3 r� z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. h <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. U} <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. `Vu{ <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7• S�e_�(r jfY,eO a o ro <br /> H 3 3 0 0. <br /> Fj <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 declare that I recognize that this <br /> Information 1 am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I ,� a <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 have <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. a o o w o <br /> 6 O FyY <br /> OWNER'S SIGNATURETrkO See n j 2° <br /> ZONING ADMINISTRATOR SEP I $ 2012 <br /> F <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF I NCE N ti o N o <br /> BURNETT COUN <br /> ZONING <br />