Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 a Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> OWNERI TELEPHONE <br /> E � O <br /> MAILING ADDRESS n ! O <br /> �iL / <br /> PROPERTY ADDRESS <br /> u_ � <br /> LEGAL DESCRIPTION(see tax receipt) C Q <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE AG-1 ADDITION ❑ c 1 <br /> TYPE OF PERMIT(S): Sc� 3S U1 rh, <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: <br /> o' <br /> ' (Home Cabin,CommerciafBusiness; Bedr6om; Deck;etc.) j� <br /> BUILDING CONTRACTOR: —�%{IA( Cn <br /> 4/tytopYa d/ "e S�/]PL ?3 (n <br /> m <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. T 3 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) <br /> O a� <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T ,;-D ? <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m v A <br /> NORTH(N). mCD <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m .31 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <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 I W <br /> BUILDINGS, ROADS,LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. ) N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS (� 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. /W o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. Ul <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: o <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. O <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 U1 <br /> SETBACK AREA. <br /> 5. <br /> 6. <br /> 0r,- a > <br /> 3acoR m <br /> ] N <br /> _ <br /> Z N ry 0 0 0 <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my – r»' p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of d a �„ S <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I recognize m o m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m l7 <br /> sue a permit. I further ac ce I liability which ma e a result of the County of Burnett relying on this information I am d <br /> providing in this applicaCagree to pernit unty offi als charged with administering county ordinances or other S m <br /> authorized person to ha a ac s to th above esc ibed emises at any reasonable time for the purp a of insp tion. m <br /> T <br /> 0 : <br /> SIGN HERE �_ ! /� <br /> (Signature of owne or building contractor) / (date `J a . <br /> ZONING ADMINISTRA OR (� <br /> <) 0 N)fA N <br /> N (TNN O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 <br />