Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -CD 0 0 <br /> APPLICAT N FOR LAND USE PERMITS 3 <br /> OWNER /yj 4011 /9 i2li TELEPHONE <br /> 99 _ `�'��Aff,2s <br /> �O <br /> MAILINGADDRESS <br /> r � <br /> 0 <br /> PROPERTY ADDRESSC ! _. <br /> LEGAL DESCRIPTION(see tax receipt) 3)1 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ (n ° <br /> TYPE OF PERMIT(S): T <br /> FILLING/ DING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ o' <br /> -70 <br /> STRUCTURE/ADDITION USE: n <br /> (Hom bin; Commer 'al Business; Bedroom; eck; etc.) (n <br /> W <br /> 2. <br /> BUILDING CONTRACTOR: m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. pT- <br /> ;0 N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> "n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 6 W A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m 9 <br /> NORTH(N). y o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S)TO m <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF Z <br /> LAKE, STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 9 <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. :�E Q <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N C1 <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. F <br /> o � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: <br /> c <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 O <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER ( � <br /> SETBACK AREA. v� <br /> 5. <br /> mcw0Oaf wM <br /> 6. m z3 �am � nfD � <br /> 0IDCy ."' o � 3 <br /> 7. Z CD0 <br /> — u, : m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m A <br /> ( 9 Y ) Y Y Gr7 -4 c <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of W0 <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize 'D o <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CD <br /> G) s <br /> sue a permit. I further accept all liability which may b result of the County of Burnett relying on this information 1 am W : o : <br /> providing in s plication. I e to permit c u icials charged with administering count r n w <br /> authorize erson have�cc s t the above de premises at any reason ble n ° a <br /> n <br /> D : <br /> j n ; <br /> SIGN HE ! F n <br /> I re of or building contractor) (date) O <br /> JUN 2220 <br /> ZONING A ISTRATOR <br /> �vi Efl fA 69� N <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING <br /> BURNETT COUNTY O N Cn W W N O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUAIWCE <br />