Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator _U o° o <br /> APPLICATION FOR LAND USE PERMITS 3. o <br /> OWNER f ,} TELEPHONE 7��� �JJ�-I0D�U <br /> MAILINGADDRESS u) !rj G 1'tV r✓�. /�]Z OCfC�icl PAR <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION(see tax receipt)SEJ L") <br /> d/� C S� v / I m <br /> 1 rr--yy r� <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ ^ U) \' <br /> TYPE OF PERMIT(S): (Ju <br /> FILLING/GRADING El CAMPING UNIT El SUBDIVISION El <br /> STRUCTURE/ADDITION USE: <br /> G*Ayg. <br /> (Home/Cabin; Commercial Business; elm; Deck; etc.) rn <br /> BUILDING CONTRACTOR: <br /> v <br /> A PLOT PLAN MUST 8E PROVIDED ON AT LEAST AN 81AX 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> O - <br /> A m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O C <br /> -n <br /> TZ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m --,) A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m J�,9 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 9 <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO <br /> BUILDINGS,ROADS, LAKE, LOT LINES. <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N <br /> 6. -. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR,ETC.,THE PLANS 0 <br /> DID <br /> 'MUST BE SIGNED AND DATED BY THE OWNER. o I <br /> o � W <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. a <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ! <br /> ISSUANCE. O <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> TRACK ARE 3 � p <br /> 6. �"T" ®6CcS/)'1 �f— '?rr�r-` la0c�.� �fiZ'°�l oVl..� — <br /> mOr- DODO <br /> 6. / This structure to be used as private residential g n 3 a 0 x ' " a <br /> S. <br /> garage/storage onl7. y. Not to be used for human z = a "o y ' a <br /> habitation. _ " [ [ m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my j (j c <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d "' <br /> all Information njqbayi <br /> ' this application(including any accompanying schedule)and I further declare that I recognize [ m E ! m <br /> that this informroviding will be relied upon by the County of Burnett Wisconsin in determining whether to is- G' w <br /> sue a permit. I rt <br /> pt all liability which may be a result of the County of Burnett relying on this information I am m o <br /> providing in thin. I agree to permit county officials charged with adminis at <br /> authorized pensaccess to the above described premises at any reasonable r e s m 'a <br /> m <br /> 5 D : <br /> SIGN HERE <br /> (Sig t of owner ilding contractor) (dgre)rtpp[ <br /> ZONINGADM IST TOR <br /> OCT1� [CVW�JJ <br /> Ll <br /> BURNETT COUNTY <br /> ER fA fA fR N <br /> O N f n W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING <br /> THIS-"MIT SHPL4 PIR�F�n_ONE YEAR FROM ATE OF ISS�A_I-CE f 1 l <br /> (y)1,_ ems} rTaI � �j �Q7 t� Ver <br />