Laserfiche WebLink
Burrfett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrato'�0 o <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N <br /> N <br /> C <br /> OWNER ►mooTELEPHONE <br /> CD <br /> HOME ADDRESS I DSDO I D8 n ' P'aC� "l Inl� s��►P O <br /> EMERGENCY/FIRE NUMBERpr lo-std ✓1Q ROAD NAME <br /> Cn,� 11 <br /> LEGAL DESCRIPTION(see tax receipt),C��`1 ( T <br /> W m <br /> ` 2 <br /> DWARAGE/ACCESSORY STRUCTU DDITION ❑ PRIVY ❑ 1 0 <br /> TYPE OF PERMIT(S): ' <br /> FILLING/GRADING ❑ CAMP IN UNIT ❑ SUBDIVISION ❑ �' <br /> STRUCTURE/ADDITION USE: 101. Y1 G 2 RCg '7 D X 90 <br /> (H a/Cabin; Commercial Business; Bedroom; Deck;etc.) <br /> BUILDING CONTRACTOR: �//Yf C-0ref—TA f <br /> U <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. T - ^' <br /> N O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O m <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n i <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> n <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES, (B)BUILDING(S)TO m �, 3 <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. o <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. N -11411 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. M --1 ' <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. o <br /> CONDITIONS OF PERMIT: I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT O'( + ' <br /> ISSUANCE. ' IW <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY Gj <br /> PERMITTED. Q <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. Phis structure to be used as Private residential <br /> garage/storage only. Not to be used for human (D M d° ° o a f m <br /> 6. habitation. <br /> COD "<i B am O� °' 2._ ;U <br /> 7. Z : mm2 . m -I <br /> o -n ZI <br /> - Cn i m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) O <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofm 0 m <br /> C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m l7 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- C <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 <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. m <br /> T <br /> (D <br /> (D <br /> SIGN HERE '—' a2 <br /> (signature of owner r b di ontra to (date) <br /> ZONING ADMINISTRATOR <br /> TOWNS IP PERMITS MAY BE REQUIRED � q1 <br /> V <br />