Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator CV o Z <br /> APPLICATION FOR LAND USE PERMITS 4 <br /> 0 <br /> 2 " <br /> OWNER 17c+��ur�t Caics SD TELEPHONE 103 <br /> m <br /> � <br /> HOME ADDRESS 7/g So,+V-, SPr, O <br /> . (�ve. L a�ji ans p TL 0.S 0 <br /> r <br /> 0 <br /> EMERGENCY/FIRE NUMBER ROAD NAME Tho.•njoso, <br /> lc:)•t a e-S V rL pJe 98 �rd-+c 33/ I C� <br /> LEGAL DESCRIPTION(see tax receipt) fJpG .4t 3/ o <br /> `i <br /> TYPE OF PERMIT(S):DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION o <br /> a <br /> 5. <br /> o' <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION � <br /> N <br /> 7 <br /> STRUCTURE/ADDITION USE: 5+C:e5 +0 La kL' <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) M <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> 0 a C <br /> DIRECTIONS FOR PLOT PLAN DRAWING• (AERIAL OR TOP VIEW) T <br /> 7! Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m 'p <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m S c <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, <br /> STREAM OR RIVER. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- �C <br /> INGS,ROADS, LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N 1 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. m c <br /> O <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE R, 0 <br /> ISSUED. n <br /> .. �� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Zc O <br /> CONDITIONS OF PERMIT: Jv <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. (X j <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 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS SPECIFICALLY PERMITTED.5. <br /> 6. txA /��/����� `�4 � Aim a A <br /> 3 <br /> v <br /> Cmmoe <br /> w <br /> _. <br /> v . <br /> 0 .4 <br /> 7. Z : F �q , <br /> o : <br /> _CA m <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my vi 1 ; p <br /> knowledge and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m E S <br /> all information contained In this application(including any accompanying schedule)and I further declare that I recognize B 5i <br /> that this Information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- O <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 d <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. <br /> � m i <br /> SIGN HERE /� -C2 to_Q 7 w <br /> (sl afore of br b Idin r) (date) <br /> ZONING ADMINISTRATOR b �;2 <br /> \jINH iN NMS <br /> N N N N N <br /> N <br /> N O N N O O <br /> T WNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 <br />