Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 @ Z <br /> APPLICATION FOR LAND USE PERMITS j ° <br /> rn o 0 <br /> � <br /> N <br /> C OWNER D O C7 <br /> TELEPHONE � Ila- <br /> (A <br /> en I-7 O <br /> MAILINGADDRESS <br /> 21 "Ig Ne1���.d V/ ©uKJal M :ham ° <br /> PROPERTY ADDRESS 66(�S S <br /> V Q <br /> LEGAL DESCRIPTION(see tax receipt) � 1 �' y <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE co,IdJ ADDITION ❑ '. <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ CL r <br /> STRUCTURE/ADDITION USE: e o <br /> / (Home/Cabin; Commercial Business; Bedroom; Deck; eettc.) e et C <br /> BUILDING CONTRACTOR: UL /� Q fT1�tAGI Vl �'�-4-41)etc.) <br /> /3 4 <br /> S (_A <br /> � o <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/z X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 �. <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n 3 � <br /> O — <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O <br /> n o _ <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. -n c' Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m (IZA ' 3 <br /> CENTERLINE OF ROAD,(C) BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF 7 <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 0 A, <br /> MUST BE SIGNED AND DATED BY THE OWNER. 2 <br /> ot <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN n <br /> a o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o �) <br /> CONDITIONS OF PERMIT: � t <br /> d <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. O <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. C`/ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS. ETC.. ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. This structure to be used as private residential <br /> 6 garage/storage only. Not to be used for human X m 0 d > o a o m <br /> habitation. ; s a Q n A <br /> o <br /> .o m C y : o 5 — <br /> 7. Z C in m 0 <br /> m : Tom . . m <br /> I declare that this application (including any accompanying scneouie/ nas Deen exammea oy me ano to the Dest of my j q O <br /> u <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of a) 0 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 ° to <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 G)d o <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasona c n. m <br /> T a <br /> CD a <br /> SIGN HERE m <br /> to n <br /> ( ' ture of o ner or building contractor) (d e) W o <br /> ZONING ADMINISTRATOR 7 <br /> 1205 <br /> 69 69 fA 6i�+N <br /> O N 01 l W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY C `� <br /> THIS PERM � <br /> IT SHALL EXPIRE ONE YEAR F D TE 0 ISS �ING <br /> FROM a s �,s+�I��-h�oh <br />