Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator ' o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> N O W <br /> OWNER TELEPHONE/ <br /> -7 o <br /> ID <br /> HOME ADDRESS c'' gkMA 6,401L14AJI' &)Pra j2k?r' , eAZ ,�, z 9 <br /> r m <br /> 0 <br /> EMERGENCY/FIRE NUMBER A/G,T 4 3 ROAD NAME L',"7A- 8 L� A �T <br /> d'T 3 i1I 77# P4 47` AY G1F4)2 Sky' /94-Ak-S <br /> LEGAL DESCRIPTION (see tax receipt) o «'73C-0 / 4. A AjID 3 0i=�Si:i,i11 <br /> 'c of elF.TAc'rr'� , c`Di <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE 1:1ADDITION 1:1PRIVY ❑dV� t In O <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING NIT ❑ SUBDIVISION ❑ L1 <br /> 3 :5. <br /> 6096,J A7� `x GIJ c cis - <br /> STRUCTURE/ADDITION USE: / AL lE� ; 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.)w�¢7�A` t%� C �O <br /> BUILDING CONTRACTOR: %, /�� ���i�% /S ���4iC.�(j /�`/ Er <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR B. <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. /^/1ZJ m r <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) rJ¢� 4C;jb `� 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m C? <br /> NORTH(N). y o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <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. P <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. ( c <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. o o ) <br /> I o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a S <br /> NEEDED. 0. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z ' <br /> CONDITIONS OF PERMIT: a <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT RIJ1 <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. �1N <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY I <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> S TBAC AREA. n / �Q .� <br /> 5. jUj �(� or LAG�O wi d hl'� �Jf �t HCl l-! <br /> 6. m � 'a , ' a m <br /> - A <br /> T r� c0 , og <br /> B <br /> — En <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) c p <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of m c <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize mm m <br /> that this information I 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 O m <br /> providing In this application. I agree to permit county officials charged with administering count ordinances or other °Ci 0 <br /> P 9 � PP� 9 P t1l 9 9 Y CD <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. -n E E <br /> CD i <br /> SIGN HERE 7 r� � <br /> (sig atuowner or building c tct <br /> aor) (data' <br /> ZONING ADMINISTRATOR cn <br /> • cp En cn fn t»fn <br /> N NfT NNU [T <br /> VI VI O Vt O O O <br /> 0 0 0 0 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED o3�jO 0 <br /> / 0000000 <br /> p <br />