Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator CD o 0 <br /> APPLICATION FOR LAND USE PERMITS . T <br /> r <br /> y <br /> C <br /> tU <br /> / n <br /> OWNER �T A��_Lj�(�7�f1 TELEPHONE 7//cl•✓�[✓��/Sa 7 _ vp <br /> `D O <br /> MAILING ADDRESS �lL,//�S✓ j?' b /a✓c�ydE ///I/ 2L(� U�J'I'1� ^� `S^ `'// ^nr <br /> PROPERTYADDRESS Y573 Ly//}1S/✓�An/ ZJ t' W �^' s <br /> LEGAL DESCRIPTION(see tax receipt) SA' 71/1 /1 pCSWI " P2/0 <br /> T(S): <br /> � 0 o` <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE I� ADDITION 0 <br /> TYPE OF PERMIn <br /> IL NG/GRADING ❑'I CAMPING UNIT ❑ SUBDIVISION ❑ ' <br /> STRUCTURE/ADDITION USE: �[� /C7 <br /> (Hom abin; Co merci I Business; Bedroom; Deck; etc.) ? (7 <br /> BUILDING CONTRACTOR: <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n 3 ft <br /> RETURNED. <br /> ILLEGIBLE PLOT PLANS WILL BEA y XJ Q <br /> DIRECTIONS FOR PLOT PLAN DRAWING: II(AERIAL OR TOP VIEW) 0 a 1 <br /> _n Q� � <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL ALL BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE � 3 <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE(FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDING(S)TO m z <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF o <br /> LAKE, STREAM OR RIVER AND MEAE UREMENT TO WETLAND AREAS. <br /> 4. SHOW THE LOCATION OF THE WELL,(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO O <br /> ` Z> <br /> BUILDINGS, ROADS, LAKE, LOT N <br /> LIN S. ` <br /> 5. INDICATE IF A WALKOUT BASEMEN IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. 7 <br /> 6. IF SEPARATE PLANS ARE SUBMITT D BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS 2. <br /> oik <br /> ) <br /> MUST BE SIGNED AND DATED BY T E OWNER. J O C n <br /> o �1 <br /> NOTE: BUILDINGISTRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN Q) <br /> NEEDED. Y' <br /> Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. ° t <br /> CONDITIONS OF PERMIT: t� <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT r " <br /> ISSUANCE. W (� 1 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. Ll <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY � <br /> PERMITTED. ' G <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA <br /> 5. (1V ' Fp 0Y_ iD o1YW-M <br /> i A co n r D O m <br /> GE m m 0 mafm <br /> 3 a� � _ `° z <br /> �' 7 N C y N 0 = 3 <br /> 6. Z cm � o <br /> O N T� m <br /> 7. <br /> I declare that this application (including any accompanying schedule) has been examined b me and to the best c of N <br /> D <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy ofr-ni <br /> co, m <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to 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. 1 agree to permit county officials charged with administering county ordinances or other ? j <br /> ion. a <br /> authorized perso to have access to the above described premises at any reasonab m n. <br /> SIGN HERE (d te) <br /> (signatur f owner or building contractor) 1 <br /> ZONING ADMINISTRATOR AuG <br /> i9 EA lfl fA fA� N <br /> (� OCNTO WTwNTO <br /> -#yy " yaw e' � ��( TOWNSHIP PERMITS MAY BE REQUIRECBURNETT COUNTY <br /> °C� S �H6 PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSQ�IQIBIG <br />