Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren, W154872 Office of Zoning Administrator -U o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> _ r <br /> N O <br /> m <br /> OWNER yon'lld M TELEPHONE �5 1170'aY-7m <br /> a , <br /> d <br /> CD <br /> 3`i7(v Maek 6tt� eview MAS ssrz� <br /> MAILING ADDRESS �,WII_ ^rC11 <br /> � " , 1 '/ <br /> PROPERTY ADDRESS Zzib©L �uN�0.rv+ ( r(�e k1� �I►'Y'-� i kA s `/972, 1 <br /> LEGAL DESCRIPTION(see tax receipt) CD �2 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION \_ <br /> TYPE OF PERMIT(S): w <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: Z- I e of .3"��'(�e"'��'Ex�C� , Yl2l.c) r;✓(1 Yy 0 (o <br /> (Home/Cabin; ommerclal Business; Bedroom; Deck; etc.) m <br /> y m <br /> BUILDING CONTRACTOR: <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR CI 3 � W <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. c,, fly <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. a po A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C o <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 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. J o O <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS J <br /> MUST BE SIGNED AND DATED BY THE OWNER. ,o i <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 7V <br /> NEEDED. i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: \ <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. R' \ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. Q• <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER ^ ` <br /> SETBACK AREA. <br /> 5. <br /> X UIOr D0D0 -0 <br /> m d m 0 m n F Rt <br /> 6. F 3 CL m x <br /> o m C y (n = 3 <br /> Z C in N O <br /> 7. O N T� <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of myA <br /> O c -J4 C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of 'm 51 <br /> PP (including Yaccompanying ) 9 <br /> all information contained in this application includin an schedule and I further declare that I recognize CD c C <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. 1 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 administering county ordinances or other [ `D <br /> authorized person to have access to the above described premises at any reasonsf r Pfi s action. D '• <br /> D n <br /> aE <br /> SIGN HERE <br /> (s' ure of ow er building contractor) (date) i <br /> <; X/ <br /> ZONING ADMINISTRATOR ✓ `- 2004 <br /> i <br /> obZoa esr, aC) WWN� <br /> o zlq 7 6aGwSe TOWNSHIP PERMITS MAYBE REQUIRED'^'li`l1� CI®��T� 0 <br /> 0 61 Z3 �P�'G <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF IS49 n1tto P <br />