Laserfiche WebLink
Burnett County 7410 Co.Rd. K, No.102,Siren,WI 54872 Office of Zoning Administrator -0 G) Z <br /> APPLICATION FOR LAND USE PERMITS ° <br /> e:gq <br /> i; <br /> OWNER Y'�i Q r� Q ��o_ TELEPHONE <br /> 7/5 L <br /> MAILING ADDRESS 3 S3 6 Srt � Qu 1 (r<, (c> z SY�a� w <br /> o <br /> PROPERTY ADDRESS z 9 Z 6(a <br /> Lo7- 3 CSM V16 33b (.XAI GOV Lal W vv <br /> LEGAL DESCRIPTION(see tax receipt) 30 _4 JcZ„ /,,���p/S w 4Cr eS S yu yb 2 � Ly a `o <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE -1 ADDITION ❑ v�°Z60 � o• <br /> TYPE OF PERMIT(S): c <br /> FILLING/GRADING ❑ CAMPING UNIT ® SUBDIVISION El a )� <br /> STRUCTURE/ADDITION USE: A y TO Oct 204 o <br /> (Home/Cabin;CommercialBusiness; Bedroom; Deck; etc.) � <br /> w <br /> BUILDING CONTRACTOR: -' <br /> m <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR B < � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In w <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p -7 Q <br /> m a <br /> Zt v (>i Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 WU! D <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m c r <br /> NORTH(N). C 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 <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. c <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. Q <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,CO ETC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. c , <br /> -) <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFtq TION MA ,BY31� EN � o <br /> NEEDED. J C� )LJ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. B A ��qJ Z Q <br /> CONDITIONS OF PERMIT: 09A, yj t! � ° r� <br /> 1 <br /> ISSUANCE.MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERM6 C' O r /, <br /> ,VV 11 <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. 'V(�j �'Vx j In Z- o <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY n , <br /> PERMITTED. IJ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> `." 1 1 W / M1�_X <br /> j' JU '/ // c-�.i h;,),U t- :V0 r D l7 D O -0 <br /> 6. <br /> CL M <br /> �j Z N (OD7. O y '� <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of my I ` D <br /> PP ( 9 Y ) y <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m C : v, C <br /> a^ ; u 33 <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m $ O m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m <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 o <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. n m ; cn <br /> CD O : <br /> SIGN HERE Q <br /> (sign of owner orfbuilding contractor) (date) a <br /> ZONING ADMINISTRATOR )im �Gy <br /> o E»cnvii»�'nd'i <br /> N (TNNOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED d7/77- 0(t v, O CA u, O O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />