Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No.102, Siren,WI 54872 Office of Zoning Administrator m o° o <br /> APPLICATION FOR LAND USE PERMITS <br /> 6F <br /> w ° 35 <br /> w <br /> OWNER �(� Free lyla�J /��YY\UC` ` TELEPHONE7(0 3 �5 S-(o 7 <br /> 1 yyy�� m OW <br /> MAILING ADDRESS <br /> J ' M m <br /> PROPERTY ADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) S' S t,3 Q p [/6 -1y Q <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ® ADDITION ❑ 0 <br /> TYPE OF PERMIT(S): n <br /> FILLING/GRADING ❑ CAMPING <br /> UNITE], SUBDIVISION ❑ <br /> STRUCTURE/ADDITIONUSE: Wo � aR T�`1 3CSIa <br /> Ow <br /> � <br /> Home/Cabin;Commercial Business; Bedr om; Deck; etc.) m <br /> 2. <br /> BUILDING CONTRACTOR: C,CGL-r-y <br /> 12 <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'h X 11 SHEET OF PAPER. ANY INCOMPLETE OR CD <br /> T � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> ?t v z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m jo <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE rn O <br /> NORTH 0 <br /> 3. SHOW D M)ENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO rrnn <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF N1- 'R <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <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. <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. c F <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. 0 (� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o 7 d <br /> CONDITIONS OF PERMIT: ) <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. 1 <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 /> 5.0 This structure to be used as private residential M m m 0 v a v <br /> 6. garage/storage only. Not to be used for human 9 m c y o 3 <br /> 7. habitation. o % m 'm <br /> r . m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m -m' 0 <br /> PP (� 9 Y ) Y Y � <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m e 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 m <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m ; o <br /> �s y (Do <br /> SIGN HERE d' a <br /> of ow"r or building contractor) (date) <br /> ZONING ADMINISTRATOR YI l ; i '• <br /> IV '7-1 <br /> CNn Ln N 00 <br /> '7-1 I TOWNSHIP PERMITS MAY BE REQUIRED <br /> 9THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />