Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator T 02 <br /> APPLICATION FOR LAND USE PERMITS . o <br /> r- <br /> rn O <br /> OWNER I� TELEPHONES/_SI� 70 O <br /> �/ m <br /> m <br /> MAILING ADDRESS <br /> q a d /a �tC-dieo <br /> CD <br /> _ CD <br /> o <br /> L?n 8� <br /> PROPERTYADDRESS s'O 7 b td<`�5�� ` O <br /> LEGAL DESCRIPTION(see tax receipt) 0 Z$ �, �►q _Q Z Ob n 1 C <br /> ° �. <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION CO 0 <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ L1 <br /> STRUCTURE/ADDITION USE: K A&'Ot jei— t,,,� jZ� M i GQ� Ln' <br /> (Ho e /abin; Comme tial Business; B droom; Deck; etc.) Cn <br /> v <br /> BUILDING CONTRACTOR: Qwn) <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 81/2 X 11 SHEET OF PAPER. ANY INCOMPLETE OR m3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n <br /> 0 311�- <br /> y _ <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) p <br /> '71 n <br /> I1 Z <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 <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 E <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. o <br /> 4 .SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO nI 11 <br /> BUILDINGS, ROADS, LAKE, LOT LINES. 'CJ <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 1 <br /> MUST BE SIGNED AND DATED BY THE OWNER. <br /> O � <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a. a <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z I <br /> CONDITIONS OF PERMIT: ° <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. WWW <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. rsi Ib—iS—b� <br /> p N C �' O = 3 <br /> ], Z C N O t0 <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of my A <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 C <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize m m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- m in <br /> sue a permit. I fu er accept all lmay be a result of the Rtha <br /> Is formation I am m o <br /> providing in thi a lieLve <br /> county officials ch ances or other E dauthorized per n hdescribed premises of inspection. m <br /> -nd <br /> m D ; <br /> n : <br /> SIGN HERE Ing. ti n <br /> (signatur of own building contractor ( ate) <br /> ZONING ADMINISTRATOR <br /> ZONING <br /> 69 19 <br /> ON (T W <br /> TOWNSHIP PERMITS MAY BE REQUIRED C o cn o v <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />