Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator a 3 <br /> APPLICATION FOR LAND USE PERMITS <br /> n <br /> OWNER /) 1�2•T /I C // TELEPHONE -7 <br /> f� b T <br /> MAILING ADDRESS ]X 73.9 <br /> 2 LO^)£ Roc <br /> PROPERTY ADDRESS <br /> _ 76 S/ ,4NTE 1R <br /> LEGAL DESCRIPTION <br /> TYPE OF PERMIT(S): SINGLE-FAMILY DWELLING ❑ ADDITION O DECK ❑ GARAGE/ACCESSORY STRUCTURE ° w <br /> BUNKHOUSE ❑ 59.692(1V)GAZEBO ❑ STAIRS ❑ FILLING/GRADING ❑ CAMPING UNIT❑ <br /> COMMERCIAL BUILDING ❑ COMMERCIAL ADDITION I7 COMMERCIAL ACCESSORY STRUCTURE ❑ ^ <br /> b � � <br /> STRUCTURE/ADDITION USE: I� o <br /> (Home/Cabin; Commercial usiness; Bedroom; Deck; etc.) `h Ory <br /> BUILDING CONTRACTOR: <br /> o <br /> o C � <br /> A PLOT PLAN MUST BE PROVIDED ON AN B Yz X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANSC ` o <br /> WILL BE RETURNED. Zr <br /> R <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) nm <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES(EB)AND ALL NEW 71 v = c <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, 3 <br /> AND INDICATE NORTH (N). ' <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B)BUILDINGS) 0 0 <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK w <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK (ST)AND DRAINFIELD (DF), AND ALL DISTANCES - C <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. - y <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. <br /> I P <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN DNSITE VERIFICATION MY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. n z C <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. C <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. 1I <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 7. o 0 0 o D 0 7 <br /> 'x^ 333 rA <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 m n d w a y <br /> information contained In this application(Including any accompanying schedule)and I further declare that I recognize that this v E.D D m <br /> Information 1 am provlding will be relled upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I d A a S y <br /> further accept all liability that maybe a result of the County of Bumett 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 10 c°z o : 8 L� <br /> access to the above-described premises at any reasonable time for the purpose of Inspection. o ;, -2 <br /> a 8 8 8 <br /> `j��[,///�/� _ (_ /�//,,, a /,n{n /�z �i✓�`dao d 9 A ; o 0 o g g <br /> OWNER'S SIGNATURE_ (date) o " a Z <br /> ZONING ADMINISTRATORSIm lclao(C4n n rn� : R g19 IT! <br /> �A t=f <br /> TOWNSHIP PERMITS MAY BE REQUIRED ao <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />