Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator - o° o <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> 0 <br /> o <br /> N <br /> nC <br /> OWNER � f . . TELEPHONE 9-NOK �77 8-368 n <br /> �7��� mcAS /1�OWh f`io 3Gk �r4 D o <br /> MAILING ADDRESS 7 _ f <br /> r � <br /> PROPERTY ADDRESS 11"179 8 _-6'1/.58" Ck R at►►,A �ak� <br /> P k I e <br /> LEGAL DESCRIPTION(see tax receipt) L p f 2,3+�/ �. /�SOh of m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ rn o� T <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑ CAMPIN��UNIT <br /> D❑ S(J��BDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: i` S/`o P� / Jl C90 �J <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) rn J A <br /> m c <br /> BUILDING CONTRACTOR: �e, <br /> 1 <br /> CID <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 /> C <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o J <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE 'N% <br /> NORTH(N). \ o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 30 <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. 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. o W <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS ' 'h <br /> S. <br /> MUST BE SIGNED AND DATED BY THE OWNER. 0 1 <br /> 0 <br /> O n <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: t fff444 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT r <br /> ISSUANCE. <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 <br /> 'REQ REQUIRED WATER <br /> ACK AREA <br /> 5. S-*r,,,; �/ ��/`� C—CJ�C�I / 1 a {.r/ <br /> y` --ZA <br /> This structure to be used as private residential m d 2 2 a m <br /> 6. garage/storage only. Not to be used for human Zr C y NCD <br /> o — 3 <br /> 7, habitation. o y W M <br /> m m m <br /> I declare that this application (includinc t of my <br /> knowledge and belief it is true,correct a rracy of o �_ '• O : 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- <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 o <br /> providing in this application. I agree to permit county officials charged with tbLe m <br /> authorized person to jbpve access to the above described premises at any reasd 1 If ° n <br /> • D : <br /> CL : <br /> SIGN HERE <br /> Fn a <br /> 7a, of own or building contractor) ��� date �� W i <br /> 21 <br /> ZONING ADMINISTRATOR <br /> BURNETT ( TT CO <br /> N UI W W N O <br /> UI O (T UI Cn 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING ZONING <br /> S PERMIT SHA EXPIRE ONEYEAR F OM DAT OF ISSUANCE <br />