Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administrator c <br /> APPLICATION FOR LAND USE PERMITS a <br /> N N <br /> I <br /> Q/� 1 � C <br /> OWNER wa`�QCe. 4(�e-l3 (-/ ( Q� h.f/YI,Q<7 TELEPHONE IJ <br /> io <br /> MAILING ADDRESS <br /> , -q943 ,6 6 3 o! SC ire (�Z 5 L g') <br /> 1 I (�! U C �T <br /> n <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION c m p <br /> n � n <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE 0 ADDITION 0 STAI S 0 1 o R' <br /> TYPE OF PERMIT(S): R �- <br /> FILLING/GG/� INN-G� 0 CAMPING UNLIT/0 BUNKHOUSE 0 59.692(1V)GAZEBO 0 DECK 0 � <br /> STRUCTURE/ADDITION USEI I ' 1 o � UI 9 tP <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) /',` <br /> J <br /> BUILDING CONTRACTOR: <br /> � S <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 1/2 X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PLANS �f Q <br /> WILL BE RETURNED. n <br /> � � 3o_ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> 6 <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. O <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS/STRUCTURES (EB) AND ALL NEW <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, <br /> AND INDICATE NORTH (N). I <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUIL ING(S) QJ c <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MAR c <br /> (OHWM) OF LAKE, STREAM OR RIVER AND WETLAND AREAS, AND (D) LOT DIMENSIONS. c z <br /> 4. SHOW THE LOCATION OF THE WELL (W), SEPTIC TANK (ST) AND DRAINFIELD (DF), AND ALL DISTANCES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. w O <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. C? o <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC, THE 5. <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE VHEN <br /> NEEDED. ( W N o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: O <br /> z <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n p <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. N <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER '� O <br /> SETBACK AREA. o. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE ONLY. <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. <br /> 7. <br /> I declare that this application (Including any accompanying schedule) has been examined by me and to the best of my knowledge m c <br /> and belief it Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information p 4Z <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Information I d ^ ,, <br /> am providing will be relled upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accept all c N='w o <br /> liability that may be a result of the County of Burnett relying on this information I am providing In this application. I agree to <br /> permit county officials charged with administrating county ordinances or other authorized person to have access to the above- <br /> described <br /> bo -described premises at any reasona le time for the u pos �spe5oon. <br /> OWNER'S SIGNATURE <br /> (date) o D a <br /> ZONING ADMINISTRATOR rn an <br /> COY) <br /> K < : <br /> c <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE o o <br />