Laserfiche WebLink
Burnett County 7410 Co. Rd. K,No. 102,Siren,WI 54872 Office of Zoning Administrator - o 0 <br /> CD APPLICATION FOR LAND USE PERMITS . <br /> y O <br /> DON <br /> C <br /> w <br /> OWNER �i�p�� A���� TELEPHONED X06 -.0��� <br /> MAILING ADDRESS ,Q/ �t� /D�L,. ��� �N�LIR ✓ L-�� �T�i�C.� <br /> PROPERTY ADDRESS I io/� �I 'P10)0�p VQ� <br /> LEGAL DESCRIPTION(see tax receipt) Pbrn <br /> DWELLING/BUILDING D4 GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ `, m o <br /> TYPE OF PERMIT(S): n <br /> FILLING/GRADING ElCAMPING UNIT ❑ SUBDIVISION ❑ <br /> N <br /> STRUCTURE/ADDITION USE: 14FI^,dQ6�1 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) Cl) <br /> BUILDING CONTRACTOR: <br /> v <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> M N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 'if o Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m jp <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <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 m3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF t—dZ <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <br /> 4. . SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(OF),AND ALL DISTANCES TO <br /> BUILDINGS,ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <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 <br /> v � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN m <br /> 3. <br /> NEEDED. "» <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o d <br /> CONDITIONS OF PERMIT: <br /> 1 <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <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 THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> M mwcDim ax rrn <br /> 6. m 3 am � a' fD <br /> C y <br /> 7. N N O 40 <br /> o m <br /> I declare that this application(including an accompanyingschedule has been examined b me and to the best of m – C D <br /> PP (� 9 Y ) Y Y G�� C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of w o v, <br /> o v <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognizem o fno <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> sue a permit. I further accept all liability which may be a result of the CounMle <br /> on this information I am m <br /> providing in this application. I agree to permit county officials charged yi�t nc orotherauthorized person to have access to the above described premises at an riIt <br /> r pection. m <br /> 0 o <br /> CD <br /> SIGN HERF� 'In d' '• <br /> CC�� (signature of owner or building contractor) I A;ju (dat <br /> ZONING ADMINISTRATOR ZI �� rnO <br /> ^/ W!e%fA 1A N <br /> Yrsfe JA9' Y <br /> TOWNSHIP PERMITS MAY BE REQUIRED"' ' <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />