Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v � Z <br /> APPLICATION FOR LAND USE PERMITS 3 °r <br /> r <br /> �, o <br /> N <br /> / C <br /> OWNER � �r A� C� B�$'� TELEPHONE��5�- P 3S 737 i p W <br /> R r <br /> MAILING ADDRESS �j O3 1 �Oul�l Qt� -J � f <br /> v 9 7 <br /> PROPERTY ADDRESS 3 Q 3 7 ('G � „,{,v Q a 0. 1 /1 �� � <br /> Sec�ron /9 \T°wn �/a �rtn1e /�/l.V ) <br /> LEGAL DESCRIPTION(see tax receipt) L a+ � CSM v�(9 pa �� <br /> m <br /> j� ^� <br /> DWELLINGlBUILDING GARAGE/ACCESSORY STRUCTURE � ADDITION � � � p' <br /> TYPE OF PERMIT(S): (�� � p <br /> FILLING/IG,RADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ la �q-. <br /> STRUCTURFJADDITIONOSE: ��i I I� r'O o rye sc�cc n Aa i L� D(�r�t^� o ,w, <br /> (Home/Cabin; Commercial B slness; Bedroom; ck; etc. � ' C� <br /> BUILDING CONTRACTOR: Se <br /> iu <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m _ � f�j <br /> O ��J <br /> DIRECTIONS FOR PLOT PLAN DRAWING• (AERIAL OR TOP VIEW) � <br /> T a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. T ? <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE � v � � <br /> NORTH(N). <br /> m ;" <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDINGS)TO ALL LOT LINES,(B)BUILDINGS)TO m � 3 <br /> CENTERLINE OF ROAD,(C)BUILDINGS)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. a <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. <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. � -� � <br /> 0 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN � � <br /> N O <br /> NEEDED. <br /> 1 <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. <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. <br /> m c° morinma0 � <br /> 6. f m <br /> m �'c� nm xa � p <br /> 7. Z � y �o � �m3 <br /> � � : ;,� � m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my _ °1 �� p <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that 1 am responsible for the detail and accuracy of m� ? J ' C <br /> J� �, . <br /> all information contained in this application(including any accompanying schedule)and I fuRher declare that I recognize m � � rAn <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- `� cn � <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` o <br /> providing in this application. I agree to permit county officials charged with administering couilt�erd' _ �gr�` —�',-E`'� � ? � E <br /> aut arson h ve access to the above described premises at any reasonable time for �pn I io � : � l: m � <br /> .. y <br /> SIGN HERE l � I I a <br /> (signature of owner or building contractor) (dal�l:e � �i p ': <br /> OZOZ N1NG ADMINISTRATOR / vLLII"" p ' �.I � � . <br /> a�53''J-i� BURNETl' COU � � � � `"`" <br /> _ O N W W N O <br /> TOWNSHIP PERMITS MAYBE REQUIRED ZONING o "' �" u, cn o <br />�0��� C THIS PER HALL EXPIR ON YEAR FROM,DAT F ISS ANCE <br /> �m��-�-�e--��� �����o �'e��,ld �e.s�- 9`rte <br />