Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 'D o Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N <br /> N <br /> OWNER ..� �V� TELEPHONE &)3 — <br /> m <br /> O <br /> MAILING ADDRESS m <br /> 4 <br /> PROPERTYADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) <br /> DWELLING/BUILDING ❑ GARAGEIACCESSORY STRUCTURE ❑ ADDITION O <br /> TYPE OF PERMIT(S): <br /> FILLINGI �DIINGn ,❑ CAMPING UNIT ❑ SUBDIVISION ❑ / � a <br /> STRUCTURE/ADDITION USE. r LQ((.0 f/(-,/ ��) <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) v <br /> q <br /> BUILDING CONTRACTOR: ����l/+ i C2-- { <br /> v ^, <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> M m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n <br /> m <br /> M v Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). VCi 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 o <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <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. tQ <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N V r <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS -4 <br /> MUST BE SIGNED AND DATED BY THE OWNER. O 1 <br /> O � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN ° <br /> NEEDED. QJ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. S�) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. I <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. C� <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER r`y7 <br /> 5'a <br /> SETBACK AREA. &(%Md (.( 3 <br /> �� � -a—o <br /> 11� In� y� !l m 0 W, 0Mn � m <br /> 6.0 V (M1(/VIl �V �' 3nmx � m3 <br /> Pi NCymO <br /> Z in O O to q <br /> 7. O T� m <br /> I declare that this application(including an accompanyingschedule has been examined b me and to the best of m — D <br /> PP ( 9 Y ) Y Y O 'c C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m Z; <br /> a cn : <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m O <br /> M: mo <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 County of Burnett relying on this information I am w <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access to the above described premises at any reasonable time for the purpose f inspection. m o <br /> �3 <br /> SIGN HERE <br /> (signature <br /> (signature ner or building rector) (d e) ' <br /> ZONING ADMINISTRATOR >�� (n<n <br /> EAHEA di N <br /> 01 <br /> �N (T NNOO <br /> ,C/(T O N fT O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />