Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator -V �o <br /> APPLICATION FOR LAND USE PERMITS <br /> °-4 ( o <br /> OWNER l TELEPHONE -3916' \` <br /> L ) , �Ne 4- -sue o5L c.,.N D -7,s y83 a <br /> HOME ADDRESS <br /> EMERGENCY/FIRE NUMBER ROAD NAME <br /> f <br /> LEGAL DESCRIPTION(see tax receipt) L o N r? vyfi, f i� a SV.Gt ow .3�� r`l� N J��� 2 sz� <br /> e-/y we sT 7-a w w C 5- oYr_ rn <br /> TYPE OF PERMIT(S):DWELLING/BUILDINGGARAGE/ACCESSORY STRUCTURE ADDITION v S <br /> S.S. <br /> �p <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION 0 <br /> to <br /> / f <br /> STRUCTURE/ADDITION USE: 1V C'tn� G��.�� i �`'1 fii <br /> (Home/Cabin;Commercial Business; edroom;Deck;etc.) "a C � <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR In <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) <br /> o UI Z <br /> t. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m �A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> Co <br /> 3. SOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m3 <br /> CENTERLINE OF ROAD, (C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF LAKE, Z <br /> STREAM OR RIVER. ° <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- <br /> INGS,ROADS,LAKE,LOT LINES. \' <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. N O^ <br /> IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS g.) <br /> MUST BE SIGNED AND DATED BY THE OWNER. CD <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE I <br /> a o <br /> ISSUED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> sONpjTjQ�S OF PERMIT: v J <br /> V>/DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT C <br /> ISSUANCE. (�, <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 1 "\ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. � <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, O <br /> PONDS, RIVER UNLESS SPECIFIC Y P RMITTED <br /> /� <br /> 5. ,l e 2�a ��yv ( � <br /> //fj 9r/ O ; perM. 0)°a ? v <br /> /f nda <br /> 6. rasit] ' v 9 two : =m3 <br /> 7. 1'/ / 7 �2�rce— �11ct– »71cU Da P5. o E � i <br /> —w: i m <br /> I declare that this appli ation (including any accompanying schedule) has been examined by me and to the best of my g '; C <br /> knowledge and belief it is true,correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of U a E <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m i t7 <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 p <br /> providing In thisa plication. I agree to permit county officials charged with administering county ordinances or other e <br /> authorized person tip have access tope above described premises at any reasonable time f inspection. m <br /> SIGN HERE <br /> (signatur of nero uildi tor) r ate <br /> ZONING ADMINISTRATOR 2 <br /> oft <br /> HNfgHHHH <br /> L. (N71 f.Nll O fN71(n O O <br /> 0 0 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 <br />