Laserfiche WebLink
onDnp. <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. 4 <br /> r <br /> C <br /> OWNER --�-��.v.p. A, � �'j� TELEPHONE o <br /> m <br /> HOME ADDRESS I I enA) G( S tU , <br /> EMERGENCY/FIRE NUMBER I a ROAD NAME 'p, bP m <br /> / DO <br /> LEGAL DESCRIPTION(see tax receipt) OP I (r� � LJ — y(� — / N 43 <br /> o (1 <br /> TYPE OF PERMIT(S): DWELLING/BUILDING-GARAGE/ACCESSORY STRUCTURE ADDITION Cr <br /> a <br /> s. <br /> N <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> ca <br /> m <br /> i 1 � <br /> STRUCTURE/ADDITION USE:^� V S �C��CXI� U � fir t <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) ro <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR m 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> w <br /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C - n <br /> NORTH(N). y 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 LAKE, Z <br /> STREAM OR RIVER. ° <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. N <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. f'c <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE q ° <br /> ISSUED. 2 <br /> r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o G <br /> CONDITIONS OF PERMIT: <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. C� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY t' <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 /> 5. A - m m 0 0 .0 <br /> L <br /> m <br /> 6. CHwos3 <br /> _N M <br /> M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my r c C <br /> knowledge and belief It is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of ii <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize ' m m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m O <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 m <br /> authorized person to h.We access to the abo a described premises at any reasonable time for the purpose of inspection. m <br /> (D : <br /> m : <br /> SIGN HERE <br /> g lure of own r ilding contractor) (date) (/) <br /> a: <br /> ZONING ADMINISTRATOR <br /> CA w <br /> N N P N N <br /> OI V7 O V1 O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 <br />