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 �. <br /> ^' r <br /> w O <br /> N <br /> OWNER (�l� P!� K��� TELEPHONE y_ g l 7(J <br /> , I m O <br /> MAILING ADDRESS ScA �, VC1 A LJe� s(L PI- Ois 5-yfes/3 <br /> r � <br /> o <br /> PROPERTY ADDRESS 5 ?J - <br /> LEGAL DESCRIPTION(see tax receipt) ��l G _-ry(),v 2 t5 L'/ m <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ rn ° <br /> TYPE OF PERMIT(S): cr <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ �` <br /> {{I� �,,!n1 N <br /> STRUCTURE/ADDITION USE: 3I^�Ii1E �Zcmtj: C✓ We0tn%L ° <br /> (Hoge/Cabin; Commercial Business; Bedroom; Deck; etc.) m <br /> BUILDING CONTRACTOR: S0-1 <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INMPLE�rOR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. L5-yt� ;Z;4 O <br /> //77 �) M m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) d3/ m o <br /> '-I o Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m jo <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> C c <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 V 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. 0 <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS i <br /> MUST BE SIGNED AND DATED BY THE OWNER. c o <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° Q) <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT U1 S <br /> ISSUANCE. t <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 THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. f1w L[t►u, yUj(—}'0 (ee- CSolel Q1- �rQNc$'FG &A'145-s miry P�QcL\ <br /> m 3C o'NmnmW <br /> O Z y O :3ID <br /> (C <br /> UGr Aare Q(..sAj2'--) bN AonhC6' P v <br /> 1 declare that this application (including an accompanyingschedule has en mined b me and to the best of m ^� ` <br /> PP (� 9 Y ) Y Y C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize II ,,l, G <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Is W <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am ro ` <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have acce s t ab a descn a remises at any reasonable time for the purpose of inspection. m E <br /> - o <br /> m . <br /> SIGN HERE c r" ' <br /> ature or or building contractor) (date) o. <br /> ZONING ADMINISTRATOR <br /> iL <br /> TOWNSHIP PERMITS MAY BE REQUIRED I <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE U� <br />