Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Admi istrator v OZ <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> ^ r <br /> m o <br /> N <br /> C <br /> OWNER ,r y TELEPHONE <br /> O G :C%4 \!•ILK r�G t` • T- -74 <br /> O <br /> d <br /> m <br /> MAILINGADDRESS kl,3.3 CJ A 't: '4r-e _^ O <br /> 5 s � � <br /> r � <br /> PROPERTYADDRESS 14 .�y,m•. WZ ,{ I �o\' <br /> Vv <br /> LEGAL DESCRIPTION(see tax receipt) cn'm ' g I rn <br /> I-7( m <br /> DWELLING/BUILDING LJ GARAGE/ACCES$ORY STRUCTURE El ADDITION ❑ (n <br /> TYPE OF PERMIT(S): a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑'. SUBDIVISION ❑ n <br /> N <br /> STRUCTURE/ADDITION USE: rv.0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) .ti <br /> m <br /> BUILDING CONTRACTOR: <br /> m <br /> Z � <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/.X 11 JHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n 3 <br /> ;a y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> -n n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 � A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m `°, <br /> NORTH(N). <br /> n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHW )OF <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <br /> Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCE TO <br /> BUILDINGS,ROADS, LAKE, LOT LINES. L <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N\p <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,T IE PLANS1 I I 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. W <br /> 1O £ <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. ') <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <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 /> W W m 0 M n :m <br /> 6 .m x 3 <br /> 7. Z c in m o io -i <br /> O N TI'S m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the est of m — :' : v : O <br /> PP ( 9 Y ) Y Y <br /> knowledge and belief it is true, correct and complete. I acknooledge that I am responsible for the detail and a curacy of d n N C <br /> all information contained in this application (including ny accdmpanying schedule)and I further declare that I recognize 0 [ m <br /> that this Information I am providing will be relied up by the County of Burnett Wisconsin in determining wh that to is- <br /> O : 0 : <br /> sue a permit. I furter accept all liability which ma/be a result of the County of Burnett relying on this Infor tion I am d ; o <br /> providing In this plication. I agree to permit c ty officials charged with administering county ordinancesor other <br /> authorized perso to have access to the above ribed premises at any reasonable..t' ose of it s action. ` m <br /> v <br /> uj Lu I 1W <br /> m > i <br /> SIGN HERE <br /> (signature 6f o ner or building contractor) I (date) o <br /> 0 <br /> ZONING ADMINISTRATOR <br /> .. t,"' <br /> +Mdi fAM� N <br /> O N U W W N O <br /> TOWNSHIP PERMITS MAYBE REQUIRED 13URNETTCOUNTY <br /> o u o u v u <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF'SSU&MING <br />