Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,W154872 Office of Zoning Administrator _ o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> N <br /> C <br /> (D <br /> OWNER t) N S flT� TELEPHONE0 <br /> �y '1t— 1 �� I�dn m <br /> MAILING ADDRESS Z j' 1 LR Kt_ V i E o RU S 1 i u'–I" ` (7'7 D 12 O <br /> nn ,, r <br /> PROPERTY ADDRESS Z,5-199 LRk,),= ) EV3 1ZQ S II�,N W� 5-19`72- <br /> 3 <br /> -1972 1 <br /> T, 39 IV — I uv-j <br /> LEGAL DESCRIPTION(see tax receipt) L p7 5 I 1 2 r3 <br /> 7LKa M OV N D m <br /> i <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORYSTRUCTURE ❑ ADDITION <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITION USE: 0 r <br /> (Home/Cabin;Commercial Business;Bedroom; Deck;etc.) t� W <br /> BUILDING CONTRACTOR: <br /> 1 <br /> v <br /> m <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 /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) Oa <br /> In -6Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m S <br /> NORTH(N). <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. o <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO C� <br /> BUILDINGS, ROADS,LAKE, LOT LINES. `e C� <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, CONTRACTOR, ETC.,THE PLANS 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o f <br /> q " 1 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN 0 ► <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> 0 <br /> CONDITIONS OF PERMIT: 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 <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. <br /> Di > <br /> m mrOO <br /> OR <br /> 6. 3 n mrx a m <br /> 7. Z m o =1 <br /> o m <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my �j ID <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy ofm n v+ <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- <br /> sue a permit. I further accept all liability which may be a result of the Co of-B 1 O' <br /> pe p ty y 4r ytng,pnthis information I am m <br /> providing in this application. I agree to permit county officials ch I d ih;s r g c�–'upty,ordinances or other o <br /> authorized person to have access to the above described premise �jkohibt ¢r 1fiR Iou1 pose of inspection. m E oCD <br /> `. <br /> CD mf <br /> SIGN HERE <br /> (si to of owner or building contracto► L (date a <br /> ZONING ADMINISTRATOR . <br /> J oa ��� ON <br /> N (N N to O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED � P� � 00 <br /> ��0 -14 <br /> c3/70a3�aa- a« <br />