Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator -D G) Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r C <br /> N O XJ <br /> N <br /> OWNER m j C// P , © Trn0 <br /> TELEPHONE 7�5 -3 5 /T <br /> MAILING ADDRESS /1 /f i// ��o r/ Ar. p"i <br /> r m <br /> PROPERTYADDRESS t o <br /> r <br /> LEGAL DESCRIPTION(see tax receipt) <br /> PND a4�--S9 / <br /> l� m <br /> DWELLING/BUILDING El GARAGE/ACCESSORY STRUCTURE ADDITION ❑ o' <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING E CAMPING UNIT ❑ SUBDIVISION Ela <br /> STRUCTURE/ADDITION USE: LJ <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) y <br /> m <br /> BUILDING CONTRACTOR: S P <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. OT <br /> n <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) OM <br /> CD <br /> -n a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m v 7 <br /> NORTH(N). m n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m ` 3 <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. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO o <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 �C <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <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. Z n <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. (� T <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 U <br /> SETBACK AREA. <br /> 5. S- <br /> 6. <br /> 6. m 0r' 0 > 0 -U <br /> D g am 0a � <br /> 7. 'O CD C N N O_ <br /> Z N 0 0 0 <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my — N A <br /> knowledge and belief it is true, correct and complete. I acknowledge that 1 am responsible for the detail and accuracy of d�, �„ C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize CG o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- \' M <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 <br /> premiseA at any reasonable time for the purpose of inspection. <br /> -nCD <br /> o <br /> SIGN HERE 7..2?_ 03 d, w <br /> (signat of owner or b ding ntractor) a <br /> (date) <br /> lCc � <br /> ZONING ADMINISTRATOR � (f� <br /> : <br /> f <br /> fA d1 ER EA� N <br /> N O1 N N 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED N O U N O O <br />