Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator -U G) Z <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> _ r <br /> 41 � <br /> C <br /> OWNER , Q TELEPHONE <br /> d <br /> MAILINGADDRESS �� v �� W S y�3 f <br /> r � <br /> 0 <br /> PROPERTYADDRESS FrQ 0r,k R� i <br /> 1 TU -�^ U Q <br /> LEGAL DESCRIPTION(see tax receipt) S W /4 S�S e 1 ! 1 W p� I 0 '`r�nA e �lO Dlarne <br /> DWELLING/BUILDING � GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ N <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n <br /> N <br /> STRUCTURE/ADDITIONOSE: p /Yle o <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) rn <br /> m <br /> BUILDING CONTRACTOR: tel- <br /> M <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 /> -A N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> T o. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 3 m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m 9 <br /> NORTH(N). <br /> n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF R <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 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC., THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. o o ) <br /> v <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: T�— <br /> Tj <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT I <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. lJ <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. <br /> m Wiuo � a T <br /> 6. 3 cL Ox T ;a <br /> O m Cy m = ic <br /> 7. Z y ' o � ® <br /> o n m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a in <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m c 0 0 <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 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 o <br /> CD <br /> �J m m <br /> SIGN HERE / ' 6 U 2 "' o <br /> (signature of owneror building contractor) (date) <br /> A <br /> ZONING ADMINISTRATOR F <br /> EA N <br /> i <br /> fA fA M <br /> p N N N O <br /> ^ (T 0 O (l� (T O <br /> TOWNSHIP PERMITS MAY BE REQUIRED tVjI <br />