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02/10/2009 TUE 16: 17 FAX 6123320241 Industrial Equities LLP 2001/002 <br /> rn v z <br /> Burnett County 7410 County Road K, No. 102, Siren,WI 54872 Office of Zoning Administrator a 3 <br /> APPLICATION FOR LAND USE PERMITS N <br /> OWNER �- yy <br /> �.� TELEPHONEJ�cr/�'. brv--h �olc' ,� o <br /> MAILING ADDRESS ?132 <br /> t^;1'1e S, l / r�,)J-^Wfd� v „ <br /> PROPERTY ADDRESS lC 3Sa O/�µ ? 5, 7" /ISG' /4/5 <br /> S <br /> lJ J o <br /> g y 10th < � <br /> LEGAL DE/Q.7`T / GSA) If q P iO3 r/';-t N5 54/YG0iJ &""40) <br /> TYPE OF PERMIT(S): SINGLE-FAMILYDWELLINGK ADDITION 0 DECK 0 GARAGE/ACCESSORY STRUCTURE 0 S �1 <br /> BUNKHOUSE O 59.692(1V)GAZEBO 0 STAIRS 0 FILLING/GRADING 0 CAMPING UNIT 13 R ' <br /> b <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION O COMMERCIAL ACCESSORY STRUCTURED <br /> STRUCTURE/ADDITION USE: /Alc/ap%1 - c <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) lJ j <br /> BUILDING CONTRACTOR: 5r, n N <br /> m u' <br /> A PLOT PLAN MUST 8E PROVIDED ON AN a Yi X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS G o <br /> WILL BE RETURNED. tt <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) m R <br /> S <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. y °^, n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(ES)AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB),INCLUDING DECKS,PORCHES AND OTHER STRUCTURES, �? <br /> AND INDICATE NORTH(N). o <br /> 3. 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. t7 <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES Q' <br /> TO BUILDINGS,ROADS,LAKE,LOT LINES. — <br /> S. 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 g <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCIURE LOCATIONS MUST BE STAKED$0 AN ONSITE VERIFICATION MY BE DONE WHEN J T' <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: OQ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. t^ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE Vl1 �ED FOR HUMAN HABITATION, E <br /> (-5 porV0.(iat 2et% ti: g1 F10�e ,5 fv bee <br /> 7 Mivl imum :54?44-) l.ckS off /6 rtvdt6�t JD4 h,V_ "36 "1D Gln 1elliiu oFfa "jr-0 a'y" � ^ <br /> I declare that this application(including any accompanying schedule)has been examined by me and to the best of my 3 0 ,Z P,8 a.-. <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of alln oto a <br /> Information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this ° >>m N <br /> a g w : y <br /> Z <br /> Information i am providing will be relied upon by the County of Burnett Wisconsin In determining whether to Issue a permit. i R y»y <br /> further accept all liability that maybe a result of the County of Sumett relying on this Information I am providing In this c <br /> application. I agree to permit county officials charged with administrating county ordinances or other authorlmd person to have " ,O,.2 t' <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. �/ q °� W N o$ <br /> Ci�/o/o ( � A a 12 <br /> OWNER'S SIGNATURE <br /> (date) a = 3 <br /> ZONING ADMINISTRATOR �m �lQnt �Ln �OOH $ta <br /> e <br /> G <br /> w <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE V ti 8 0 0 0 8 <br /> PC�(Yll� <br /> 4, <br /> jfC/ /1 Gi� �e9� �D'T � SLCSc12b�un � a0-6q <br /> lIS- 34q - Zt �G <br />