Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator -U o° o <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> N � <br /> CD <br /> U1 <br /> C <br /> /� ' Q / 1 !�(�,—• ��� <br /> OWNERtC e <br /> fTlY'LEPHONE ?Sp <br /> MAILING ADDRESS <br /> 0 <br /> PROPERTYADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) ;�S' `1 I <br /> m <br /> 0 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ D <br /> TYPE OF PERMIT(S): 1 a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> /� [/ N /L <br /> STRUCTURE/ADDITIONUSE: 0 SCA r o y X Oil 7 = r) <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) I <br /> BUILDING CONTRACTOR: �P <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) n 0. <br /> T <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. o <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). GG0J <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 <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. ° <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. C <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N W <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS nS. W <br /> MUST BE SIGNED AND DATED BY THE OWNER. ° <br /> o � I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. 2 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: XJ t <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT "( <br /> ISSUANCE. R, <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 QS <br /> SETBACK AREA. <br /> 5. ^ <br /> 0 01 = 8cr° aa� m <br /> 3 am Cc - A <br /> 6. v' C: o 3 <br /> Z <br /> 10D 00 <br /> 7. ° ?I,;! <br /> co : m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my r' <br /> = A <br /> �f <br /> knowledge and belief it is true,correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of a <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m 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 m <br /> providing in this application. 1 agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. -n : o <br /> m <br /> SIGN HERE o. <br /> (signa(ure of owner 'Iding contractor) r (date) i <br /> ZONING ADMINISTRATOR n <br /> ( Pi <br /> 69 Vf fA o N <br /> N T N N O O <br /> (TOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED (\�J <br />