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 /> N a <br /> OWNER sj TELEPHONE <br /> MAILINGADNO� 1/oCc2.1q0i0 Rye L«/� �r3,,rpJ, - y7i1J 'O <br /> r m <br /> PROPERTY ADDRESS G/ 3 a 7 44w5c-4, G/< T/4 .w y o <br /> LEGAL DESCRIPTION(see tax receipt) /V,c r--i- iyUJ w — TQ m <br /> DWELLING/BUILDING W GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ 2� <br /> m <br /> STRUCTURE/ADDITIONOSE: <br /> �^ (Home/Cabin; Commercial Business;`Bedroom;Deck;etc.) m <br /> BUILDING CONTRACTOR: '1 `JP y� ( Aom jq S Com 5,41 K G T�D/J d ) <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. Gi�s/��I7tq�� 0Ju� p <br /> tbAe'4 KwF'-14 S (U e- O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) �/-`,�;,, pw�r Toga -" ve,.,,'F O n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. s- � 9-5/ <br /> �/ T v z <br /> c�b� A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m (D <br /> NORTH(N). y 3 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDINGS)TO m <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. 1 0 <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 GRADEIR4' D. Uj N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, COTHE PLANS Oc, <br /> MUST BE SIGNED AND DATED BY THE OWNER.NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICAAY BE H y� <br /> NEEDED. J w V �1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. a J�N Sr o ZI <br /> CONDITIONS OF PERMIT: URNS" �OQ2 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMITI �Cr \� ` <br /> ISSUANCE. CNN6 UNj y V <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n` <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY Q <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> X <br /> W r 0 m a O m <br /> m <br /> 6. m 3amOx <br /> v' mc; yo � 3 <br /> 7. (Do <br /> o T� <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G)2 C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m n v+ <br /> 0. <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m o mCDy <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <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 o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> SIGN HERE / <br /> a <br /> (sign ure f owner or b 'di contractor) (date) <br /> ZONING ADMINISTRATOR <br /> U)69 <br /> 169 fA EA EA — N <br /> / ��� N N N N0 O <br /> (TOcn IIT 00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED ��/� <br /> U ' <br />