Laserfiche WebLink
Burnett County 7410 County Road K, No. 102, Siren, WI 54872 Office of Zoning Administra or c n c <br /> APPLICATION FOR LAND USE PERMITS <br /> OWNER ,/ LeaD / � I TELEPHONE (9J <br /> II <br /> rt <br /> MAILING ADDRESS 3g nc,flS' <br /> PROPERTY ADDRESS '30r75a el Ll ns [-h <br /> n <br /> LEGAL DESCRIPTION <br /> 5 <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION STAIRS ❑ c <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ BUNKHOUSE t7 59.692(1V)GAZEBO Cl DECK ❑ _ <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: <br /> A PLOT PLAN MUST BE PROVIDED ON AN 8 W X11 SHEET OF PAPER. ANY INCOMPLETE OR ILLEGIBLE PLOT PI ANS h \ <br /> WILL BE RETURNED. <br /> O c <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (ARIAL OR TOP VIEW) <br /> n <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/STRUCTURES (EB)AND ALL NEW y <br /> BUILDINGS/STRUCTURES (NB), INCLUDING DECKS, PORCHES AND OTHER STRUCTURES, m w <br /> AND INDICATE NORTH (N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES, (B) BUILDING(S) o <br /> TO CENTERLINE OF ROAD, (C) BUILDING MEASUREMENT(S)TO THE ORDINARY HIGH WATER MARK R <br /> (OHWM) OF LAKE,STREAM OR RIVER AND WETLAND AREAS,AND (D) LOT DIMENSIONS. c v. z <br /> 4. SHOW THE LOCATION OF THE WELL(W), SEPTIC TANK(ST)AND DRAINFIELD (DF),AND ALL DISTAIN CES <br /> TO BUILDINGS, ROADS, LAKE, LOT LINES. 0° <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. E <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC., HE _ e <br /> PLANS MUST BE SIGNED AND DATED BY THE OWNER. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MY BE DONE W EN ' (� <br /> NEEDED. _ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT. ' a Q <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. n <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY PERMITTED. t <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. ACCESSORY STRUCTURE/GARAGE PERMITS ALLOW FOR PRIVATE RESIDENTIAL GARAGE/STORAGE C NLY. O <br /> NOT TO BE USED FOR HUMAN HABITATION. <br /> 6. g <br /> � 2 95 � HIM <br /> 9 Ewe � w <br /> I declare that this application(Including any accompanying schedule)has been examined by me and to the best of my knowle ge <br /> and belief It Is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of all Information o <br /> contained In this application(Including any accompanying schedule)and I further declare that I recognize that this Informatloi i I E b: ray <br /> am providing will be relled upon by the County of Burnett Wisconsin In determining whether to Issue a permit. I further accep t all <br /> liability that may be a result of the County of Burnett relying on this Information I am providing In this application. I agree to n <br /> reL) g `" 171 <br /> permit county officials charged with administrating county gonances or other authorized person to have access to the above <br /> to 21n <br /> described premises at any rea nable time fo[the pu of spectlon. PS o <br /> aw <br /> OWNER'S SIGNATURE �A,l )ViMllz. <br /> (date) y g z <br /> P —g 5 <br /> ZONING ADMINISTRATOR in-) El a o nbi <br /> < <br /> TOWNSHIP PERMITS MAY BE REQUIRED =p «»r <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE Q� $ <br /> flfrn14 i- lef-I-Cr ptc4ed up 61 S// khc a 0-1�)D(�' <br />