Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102,Siren,WI 54872 Office of Zoning Administrator -0G z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> / / n <br /> OWNER / / TELEPHONE ,/s((�'S' 7S2 <br /> MAILINGADDRESS O <br /> T tai <br /> PROPERTYADDRESS �QO ks {� <br /> W <br /> LEGAL DESCRIPTION(see tax receipt) Vag �l ® 3 C m <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE I1 <br /> N'ADDITION ❑ (n <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADI G CAMPING UNIT ❑ SUBDIVISION ❑ O' <br /> .^� '< <br /> STRUCTURE/ADDITIONUSE: PG /h cam! y L-k) 0 <br /> (Home/Cabin;Commercial Business; Bedroom; Deck;etc.) \ <br /> BUILDING CONTRACTOR: & �✓S d <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O C <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN T T ? <br /> O SCALE. n w � � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C o <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(OHWM)OF "V <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. '� o <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. C <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FI ED. N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRA THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. / G o4 <br /> b <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATI N MAY BE o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. �ryN o <br /> CONDITIONS OF PERMIT: eGP/V1F �O3 <br /> 1. DRIVEWAY <br /> MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ZO <br /> ISSUANCE.E. N[/u O(/N, t , <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. �\ 0 <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. m 0 0OCD n0 -0 <br /> 6. 3 a 00 C% n m x <br /> ry C y 0 3 <br /> 7. Z N N O O t0 <br /> O �G M <br /> I declare that this application(including any accompanying schedule) has been examined by me and to the best of my A <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracyof C <br /> oCf. a vt <br /> all information contained in this application(including any accompanying schedule)and 1 further declare that I recognize mo <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CD� <br /> sue a permit. I further ac pt all liability which may be a result of the County of Burnett relying on this information I am m : <br /> providing in this plic n. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized persyn to h access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> M a am <br /> SIGN HERE `" o <br /> (signature of owner or building contractor)—eJ (date) <br /> ZONING ADMINISTRATOR <br /> K) <br /> fA di di N <br /> 0 <br /> N) <br /> NNNOO <br /> N O Vt N O O <br /> TOWNS IP PERMITS MAY BE REQUIRED <br />