Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> APPLICATION FOR LAND USE PERMITSV7 0. <br /> r <br /> t A 6 D n 1 p 4! <br /> OWNER JACK TMY / ETE-AS"�,4 TELEPHONE�'//S) 16 - 770,Y n � <br /> DDRESS �" m Ok/" <br /> MAILING A <br /> x#96 SAII S S Cy,f/-ET � Sgat LAKE A//. S#87/ <br /> CD <br /> QQ C#444-7- <br /> '!� <br /> PROPERTYADDRESS/yg�j �JY+1f15S ( //fJLET RD, HELL LAKE 1. 5J1871 <br /> LEGAL DESCRIPTION(see tax receipt&IAIsg -7 rn <br /> DWELLING/BUILDING K GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ to 0 <br /> TYPE OF PERMIT(S): <br /> Cr <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISI ❑ a <br /> N � � <br /> STRUCTURE/ADDITIONUSE: AtDL✓f'!!5- o2 X 4a- o xJ <br /> (Home/Cabin;Commercial usiness;Bedroom; Deck;etc.) rn <br /> m ^ <br /> BUILDING CONTRACTOR: <br /> M <br /> M <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T <br /> Of`\C'JCJ`➢ <br /> N ' <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> n a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <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 3 <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 /> 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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN W S <br /> NEEDED. tv <br /> o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. a o <br /> CONDITIONS OF PERMIT: <br /> 1 DRIVEWAY <br /> MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT JUC . Q ks <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORE <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLYw/ <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIREb V cot)lvTr <br /> SETBACK AREA. <br /> 5. <br /> m md � ma �0 ft m <br /> 'D CD C s y o j 5_ <br /> 7. Z N o <br /> O T <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracymoyf m CC, <n <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o : my <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m <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 o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. (D <br /> CD <br /> SIGN HERE <br /> a : <br /> (signature of own r builds g ntractor) (date) <br /> ZONING ADMINISTRATOR E <br /> fA EA EA Vi�+N <br /> N (T N N O O <br /> (TON (TOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />