Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 10 z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> ^" r <br /> w g <br /> OWNERUJI <br /> zE- J� / C7l,��j�l�/r TELEPHONE <br /> HOME ADDRESS a C ✓�. �� O <br /> ^ <br /> EMERGENCY/FIRE NUMBER o2 e5na'111�m2 ROAD NAME yej, ew <br /> p.�, L o T /a <br /> LEGAL DESCRIPTION(see tax receipt) ©' <br /> y <br /> Cr. <br /> TYPE OF PERMIT(S):DWELLINGBUILDING� ARAGE/A CESSORY STRUCTURE ADDITION N 3 <br /> cr <br /> n <br /> 5. <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> f <br /> IM <br /> USE: N <br /> r7� <br /> I <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) I 1 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. T 3 <br /> DIRECTIONS FOR PLOT P ANDRAWING. (AERIAL OR TOP VIEW) Q <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 23 <br /> v Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m a <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 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, p <br /> STREAM OR RIVER. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS,ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. d <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. <br /> n o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE A `•' I <br /> ISSUED. q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z w <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT W <br /> ISSUANCE. <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 75 FEET OF THE OHWM OF LAKES, <br /> PONDS, RIVER UNLESS/SPECIFICALLY PERMITTED. <br /> s. (j_, ) ell <br /> 3 CL CL m <br /> St <br /> I declare that this a Iiwtion (including an accompanying ) —ct . . . <br /> PP ( g yschedule has been examined by me and to the best of my Zg ` m <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of '• m � : C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize 01 V m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is, G3 <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 /> providing in this application. I agree to permit county officials charged with administering county ordinances or other `0 <br /> authorized person to ave access to the above described premises at any reasonable time for the purpose of inspection. P ' <br /> m <br /> CD • <br /> SIGN � w <br /> IB or Ing contractor) <br /> (date) <br /> �C! <br /> ZONING ADMINISTRATOR - <br /> NhhNNN-+ <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />