Laserfiche WebLink
Z <br /> Burnett County 7410 County Road K, No. 102, Siren,VII 54872 Office of Zoning Administrator <br /> APPLICATION FOR LAND USE PERMITS = <br /> (l - 930 6kS O?r -7 o <br /> OWNER / ! 1( / ✓Iec"a � TELEPHONE 7/S /41SG- 3 �--A L '- <br /> MAILING ADDRESSS7 /Y �/!J^ M �" <br /> r� /b� Ptlyrl-y/mow 7 10f $H9Y0 i s <br /> PROPERTY ADDRESS <br /> 6'�el'& 3 0 \ ��{-- <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING <br /> WELL NG 0 ADDITION❑r s DECK IJ GARAGE/ACCESSORY L �J <br /> STRUCTUR � c <br /> BUNKHOUSE 0 59.692TV)GAZEBO❑ STAIRS❑ FILLING/GRADING❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING 0 COMMERCIAL ADDITION ❑ COMMERCIAL ACCESSORY STRUCTURE 11STRUCTURE/ADDTON USE: O. bnCFml Busins ; BeOrom; Deck;etc.) <br /> BUILDING CONTRACTOR: Al <br /> 1 !/N/3r/45/0C /P9,,r 5 <br /> AP LOT PLAN MUST BE PROVIDED ON AN a V.X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS <br /> WILL BE RETURNED. '^ <br /> r <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) _ <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 <br /> BUILDINGS/STRUCTURES(NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH(N). =1 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(5) 5 <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. <br /> 9. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES <br /> TO BUILDINGS,ROADS, LAKE,LOT LINES. CTI J� <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 <br /> PIANS 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. i I 1I�1U^1 <br /> ) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: I TAj n `i <br /> L DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN W DAYS OF PERMIT. r(yOTyf <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORElANO ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. <br /> 9. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER �kVJ <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GAFUGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. Ci <br /> NOT TO BE USED FOR HUMAN HABITATION. (J <br /> 6. <br /> 7. p > Ocnc > s <br /> 333rt = Xi <br /> Ideclare that this application(including any accompanying schedule)has been examined by me and to the best of my3 e 9 R a <br /> knowledge and belief it is true,correct and complete. 1 acknowledge Mat I am responsible for the detail and accuracy of all � _ _ - r y <br /> information contained in this application(including any accompanying schedule)and l further declare that l recognize that this = <br /> information 1 am providing will be relied upon by Me County of Burnett Wisconsin in determining whether to Issue a permit I <br /> further accept all liability that may be a result of the County of Burnett relying on MIs information I am providing in this <br /> application. Iagree to Permit county officials charged with administrating county ordinances or other authoricedpersont, Od � ' 8oma <br /> have access to Me above-described premises at any reaso.MSl hne for Me purpose of insPe tic.. <br /> OWNER'S SIGNATURE T%G L! - — wrgm <br /> , <br /> (date) e " <br /> ZONING ADMINISTRATOR <br /> TOWNSHIP PERMITS MAY BE REQUIRED pp pp���� <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUAW&NETT COUNTY ` <br /> ZONING w <br />