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Mar 24 10 11:51a PZ <br /> nar t4 LU Ue/UUp p, l <br /> Burnett County 7410 County Road K, No. 102, Siren,WI Si4872 O(RcE W Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER / (,5l-ass g17� a� a <br /> TELEPHONE <br /> R <br /> MAILING ADDRESS 0 <br /> PROPERTY ADDRESS X J <br /> LEGAL DESCRIPTION C O <br /> TYPE OF PERNft(S): SINGLEMILY OW'E11ING❑ AODITTCN OECK❑ GARAGE/ACCESSORY STRUCTURE❑ <br /> 2. <br /> BUNKHOUSEC) 59.692(1V)GAZEBO)( STAIRS❑ fILLTNGJGAADING❑ CAMPING UNIT❑ 2. ' <br /> f <br /> COMMERCIAL BUILDING O COMMERCIAL ADDITION <br /> 13 COMMERCIAL ACCESS DRY STRUCTURE 0 <br /> 3 <br /> STRUCTURE/ADDITION USE: (Iz <br /> (HOm!/Cahn;Commercial Business; Bedeoom; Dxlq eh.) ° <br /> BUILDING CONTRACTOR: <br /> n <br /> O 3 <br /> A PLOT PLAN MUST BE PROVlOEO ON AN 9 ''A X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS G o <br /> WILL BE RETURNED. <br /> 2. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARM ORTOP y,=W) ,� S <br /> I. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. c I a <br /> 2. SHOW THE LOCATION AND SIZE OF AL_EXISTING BUILOINGS/STRUCTURES(EB)AND ALL NEW t" '9 <br /> BURAINGS/STRUCTURES(NB),INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, p. v <br /> AND INDICATE NORTH(N). J n z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING($)MALL LOT LINES, (B)BUILOING(S) <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENTS)TD THE ORDINARY HIGH WATER MARK m' I <br /> COHWM)OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND(D)LOT DIMENSIONS. p <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. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ern <br /> S. IF SEPARATE PLANS ARE SUBMITTED EY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE Q� <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER, 1\� ^ <br /> NOTE: BUILDIN G/STRUCIURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE WHEN I <br /> NEEDED. -i <br /> THIS PERMIT IS SUBIECI-TO ALL CONDITIONS LISTED BELOW; <br /> I. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WIT}iiN 60 DAYS OF PERMIT. i <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n z <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. P <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 REST09MAL GARAGErSTORAGE ONLY. Q <br /> •'^""n RE USED FOR HUMAN HABITATION. <br /> zi <br /> e. <br /> 7. <br /> C declare that thin aPPeeaum(Indudbtg any ecaaepwryi erg echedUM)Ms been enrehaad by me and to the best of my z c 3 3 'A <br /> 1m <br /> va ee ead belief It Ia true,no" end a Pleta. I admoadad00 that I em rapondble far the deal) to and sawraay of all � a <br /> Ir[errretgn conalned m thin 411911 etfan(including any asaaePirtyhrg xltedulW and 1 further dedara tbat I Naoognb a that this <br /> h94t01400n I am POeLdind wie be reked upon by ate Cbuntir of Burned Watarsln N dotemaeeas whether to bane a Permit I 3 ''° g n" Y <br /> further aeaepe all ITabdlry that rasp he a nodt Of pre Camty M Burnett railing on thin btfamnetloo I am P < 'O <br /> b <br /> aPpeaatlen. I agree to ParaR muey slfhdals eAargad arRh adminlatratl Pgpeaan to have. ^ 9 <br /> acre-0o the shove-desayad Premises at any ressamable time fer the pu�dardbrnaa or other nutl+eraad S "' <br /> mese InepeConn' , m 9 8 <br /> OWNERS SIG IAIU �+K 3-2 [f�j 8 <br /> (dste) H3�§ P, Oc2 <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE 0y M o o e e$ <br /> 1Q4e/ i(na-iLed -�O72e ConskuC�r�n <br />