Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No. 102,Siren,WI 54872 Office of Zoning Administrator m o° a <br /> APPLICATION FOR LAND USE PERMITS <br /> in O <br /> C tN <br /> OWNER y 1V 1 t �' ►"l l f �/ k(4 <br /> ELEPHONE <br /> MAILING ADDRESS 'lar,r) <br /> PROPERTY ADDRESS C <br /> LEGAL DESCRIPTION(see tax receipt) Roon e(r !R Ke ir1e.S F►'rsf A006 L014 r <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE V- ADDITION ❑ c <br /> TYPE OF PERMIT(S): Cr <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ S. <br /> N <br /> Garaq� a <br /> STRUCTURE/ADDITIONOSE: UX a 4 A - <br /> /� (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) (a <br /> Q <br /> BUILDING CONTRACTOR: DVK1✓S IL t d�� ✓ ^ n`�� �� G Z y <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'k X 11 SHEET OF PAPER. ANY INCOMPLETE OR n <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 ~ <br /> � c <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) n a <br /> -n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C <br /> NORTH(N). <br /> to o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF -fes c <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 O <br /> BUILDINGS,ROADS, LAKE,LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. O <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. tOf <br /> 7 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFI WHEN ° <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. 4�t JuN '�1 f o <br /> CONDITIONS OF PERMIT: ' <br /> JUN � ' n, �f <br /> -'^ <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF P��NE <br /> VIA <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINEZ,C'�UN7Y h Q� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY lv,NG N p <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBA AREA. <br /> 5. • This structure to be used as private residential M 0 r-a v a v "a <br /> 6 garage/storage only. Not to be used for human 3 n n m <br /> N W <br /> habitation. o w m c °= o a <br /> Z <br /> TP : M <br /> 7. m <br /> =rn: [ 0 <br /> = <br /> I declare that this application(including any accompanying schedule) has been examined by me and to the best of rn i : . <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofrn <br /> a <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- <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 �+ <br /> m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m : m, <br /> authorized perso ss to the above described premises at any reasonable time for the purpose of inspection. -n c <br /> 1 m CD <br /> SIGN HERE G i <br /> Ignature of owner or building ontractor) (date) <br /> ZONING,ADMINISTRATOR �N <br /> C► N (J O <br /> MITS MAY BE REQUIRED O <br /> I01 TOWNSHIP PER <br /> �Ig THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />