Laserfiche WebLink
G7?crm <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 o Z <br /> APPLICATION FOR LAND USE PERMITS . 4 <br /> � � N <br /> c <br /> OWNER matt B, sa"4 Wa"M TELEPHONE 612 •• Q# 14Jl <br /> HOME ADDRESS 1833 oVed4" Cig• Atooni ngtM.. (#e 55431 C- <br /> QrS <br /> "'""�" p�o m <br /> EMERGENCY/FIRE NUMBER &jWeeA730S & 731 ROAD NAME Faawtixik U 1 .. <br /> LEGAL DESCRIPTION(see tax receipt)tW.40 .K.16 064Zwiid ehouee tot 3 1 No.020 9385 O4 900 � c' <br /> TYPE OF PERMIT(S):DWELLING/BUILDING_GARAGE/ACCESSORY STRUCTURE ADDITION- Cx' <br /> c• <br /> a_ <br /> a' <br /> SANITARY X PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> y <br /> m <br /> STRUCTURE/ADDITION USE: QQX, R. <br /> (Home/Cabin;Corkmercial Business; Bedroom;Deck;etc.) <br /> M <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> C -� <br /> 7g <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 o <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m S <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE rn n <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (8)BUILDING(S)TO m v <br /> CENTERLINE OF ROAD,(C)BUILDING($)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- (fit <br /> INGS, ROADS, LAKE, LOT LINES. �l i <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. DO c <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS I <br /> MUST BE SIGNED AND DATED BY THE OWNER. (� m o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE 0 <br /> ISSUED. ci ([1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z �(� <br /> CONDITIONS OF PERMIT: c i <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 75 FEET OF THE OHWM OF LAKES, Ul <br /> POND4 RIVER UNLESS SPECIFICALLY P RMITTED. <br /> 5. - S� X51 � aIfW /�1 " S <br /> zm <br /> 6. <br /> 7. Z `• N0I,2S : -4 <br /> o <br /> _•v,. . M <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my g C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of n.E <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m O <br /> sue a permit. I further ccept all liability which may be a result of the Comer <br /> Ia Information I am 'm <br /> providing in this appli tion. I agree to pe 1 ounty officials ch o finances or other m <br /> authorized person to ve ac s o the a v ascribed premise se of Inspection. T <br /> m : <br /> Lj <br /> CD : <br /> SIGN HERE -7 1 h <br /> (signature(Ter or building con actor ate) <br /> ZONING ADMINISTRATOR /YL `Q- ggAje=UNTy <br /> N N H 6► <br /> ZONING N N N o 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br /> '00 0 c <br />