Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -o O z <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> N 0 (��\ <br /> OWNER ¢Mn TELEPHONE 6S1 647 1167 0 <br /> s�troy � c� a <br /> HOME ADDRESS1�Ij f (A"I" Apeo St Pa"t Me 55104 V <br /> CD <br /> EMERGENCY/FIRE NUMBER j8j84 ROAD NAME Pa4dat Jjd, �~ � <br /> I <br /> LEGAL DESCRIPTION(see tax receipt) ,, 07 v, <br /> I �3 77�A y� /� /7 Ntr.r�_ 0 <br /> DWELLING/BUILDING U GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ PRIVY ❑ Cn 0= <br /> TYPE OF PERMIT(S): a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> 5. <br /> N <br /> STRUCTURE/ADDITION USE: g eff-aAka = �. <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) ur <br /> m <br /> BUILDING CONTRACTOR: A70d YZI.V" &W.RV4t4 M* <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8Ya X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> A N Q <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> T z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. t7 m A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m Ii <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 <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. ' 9 <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 /> S. 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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o <br /> o � I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN a S <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. z �V <br /> CONDITIONS OF PERMIT: O <br /> 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT C7 <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 Q <br /> PERMITTED. l•!I <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOW D WITHIN THE REQUIRED WATER Q <br /> SETBACK ARE /'�y ,1 <br /> 5. 4� res o-)%- Ao fy 1prl� b�N— W/&)e�l / L�/✓ n r O <br /> m � 5 <br /> 6. <br /> 3o " �oyorP �7. coma mz <br /> - U) m <br /> I declare that this lication (i cluding any accompanying hedule) has been examined by me and to the est of my G) C p <br /> knowledge and bete it is true, correct and complete. I ackn0 I at I am responsible for the detail and accuracy of n C <br /> all information contained in this application(including any a dule)and I further declare that I recognize m m <br /> that this information I am providing will be relied upon by t 1Nn psin in determining whether to is- Lj ? : ' O <br /> sue a permit. I further accept all liability which may be a r of the �Of,, ut relying qn this information I am <br /> providing in this application. I agree to permit county o i s charged with a i e�irt�cb my ordinances or other m E <br /> authorized person t ave access to a above described ises a easonable tirhe�Tdrhh urpose of inspection. -n i <br /> CD : <br /> CD : <br /> SIGN HERE <br /> _ti ature orowner or buil I cLac <br /> ate) <br /> ZONING ADMINISTRATOR ✓J O <br /> N PP,N00 <br /> 0 0O CT 0O Q <br /> TOWNSHIP RMITS MAY BE REQUIRED I'Ihv�b/n�1/�x 0 0 0 0 0 0 <br /> ,��L�� 000000 <br />