Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -CD o o <br /> APPLICATION FOR LAND USE PERMITS 3. 15. <br /> N O <br /> C <br /> h �� a J <br /> OWNER TELEPHONIE <br /> r m W <br /> HOME ADDRESS b Z� (� � O <br /> EMERGENCY/FIRE NUMBER ROAD NAME (� <br /> LEGAL DESCRIPTION(see tax receipt) se ` _ 1\L�k)' ' (z,yI mk .WI f <br /> 0 <br /> c <br /> DWELLING/BUILDING El GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ G) <br /> TYPE OF PERMIT(S): Q a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISIONr a <br /> Cr <br /> I l' 4/ ,D' eL < <br /> STRUCTURE/ADDITION USE: IV La <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;elk) y <br /> 2.BUILDING CONTRACTOR:_ c41,L Y.d 1't fie l�xs rJ /4 11P.r IS6 Ij <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 17 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m <br /> O <br /> M N K <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) Om �\ <br /> n n <br /> ,n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. C7 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). a n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO CO) 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF \ p <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. o <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 /> 5. 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 1 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> v 9 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN (� <br /> NEEDED. M e-k <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o ) <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <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. Y <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> � vv� v�vm <br /> 6. v' m Crn " o 3 <br /> 7. Z WM q <br /> o <br /> = m: m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c i i i p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m 0 c <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m . <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- p <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett relying on this information I am m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other 2 <br /> authorized person to have acces o the above described premises at any reasonable time for the purpose of inspection. -n <br /> m : <br /> _Lm <br /> SIGN HERE 1)I WAIN � � <br /> Is natu of ow ilding contractor) (dat ) xp j <br /> ZONING ADMINISTRATOR 'v^r <br /> N N Ln N N <br /> J <br /> ut N P . P . O <br /> TOWNSHIP PERMITS MAY BE REQUIRED o 0 0 0 0 <br />