Laserfiche WebLink
Barnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator Z <br /> APPLICATION FOR LAND USE PERMITS 3, <br /> _ r <br /> N O R <br /> OWNER „_ ' C rn t TELEPHONE <br /> HOME ADDRESS SS q i 1IQ <br /> neplu`,.. J /J•7-- "S-O' / NCD <br /> V <br /> 0 <br /> EMERGENCY/FIRE NUMBER -cr ROAD NAMEtin'. <br /> LEGAL DESCRIPTION(see tax receipt) 5W Yc,( NE y(.( See , 1I T yDA/ ' l4Gf/ Cn <br /> CM) <br /> TYPE OF PERMIT(S): <br /> DWELLING/BUILDING 1:1GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ m <br /> c <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ Cr. , <br /> STRUCTURE/ADDITION USE: 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: 117e, _ Ont,E () [1n <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T (� <br /> DIRECTIONS FOR PLOT PLAN DRAWING (AERIAL OR TOP VIEW) O m `j <br /> n a <br /> _n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO CO) 0 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <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 p <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR,ETC.,THE PLANS ((`� /v <br /> MUST BE SIGNED AND DATED BY THE OWNER. -y o <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. Z <br /> CONDITIONS OF PERMIT: c <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. N, <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. � i <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY r „ YiPERMITTED. W O <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AR <br /> G <br /> 5. 0( ' � �H6L'M1 <br /> mvnr �O?o -0 <br /> CD M.6. <br /> 7. Z : y o� <br /> o : <br /> 0): 77 <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my (`f c p <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of 'm it ': 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- m 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 ppm <br /> hJ <br /> authorized person to have access tothe above described remises at any reasonable time for the purpose of Inspection. -n <br /> m : <br /> SIGN HERE <br /> ($I t re of oModing contractor) (date) <br /> ZONING ADMINISTRATOR <br /> N Nf�nN�tn <br /> V Vt ut Out O <br /> TOWNSHIP PERMITS MAY BE REQUIRED j 0 0 0 0 c o0 <br /> L#°O'V.� <br />