Laserfiche WebLink
-*�D <br /> Burnett County 7410 Co. Rd. K, No. 102,Siren,Will 54872 Office of Zoning Administrator _ o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> y O <br /> C _ <br /> OWNER �W(�i � LL�. %J���II�h//It0/ir ?�!c✓ PHONE 7166--&35-75- Z 7 0 <br /> CD <br /> MAILING ADDRESS 0* 3 :X <br /> r <br /> ,I o <br /> PROPERTYADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) !y' C <br /> IlpplbI / 4 + <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE 1:1 ION o <br /> TYPE OF PERMIT(S): v <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ �' <br /> STRUCTURE/ADDITION USE: <br /> (Home/ abin;Commercial Business;Bedroom; Deck;etc.) rn <br /> m <br /> BUILDING CONTRACTOR: � r ✓S m <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR � <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. n r, <br /> N W <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n c� <br /> -n o Z <br /> ,A--ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n d A <br /> -.2.—SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). o <br /> 3.--SHOW DIMENSIONS IN FEET OF THE FOLLOWING: Pi►BUILDING(S)TO ALL LOT LINES,iDrBUILDING(S)TO m 3 <br /> CENTERLINE OF ROAD,yr l-BUILDINGS)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 1� o <br /> �HOW THE LOCATION OF THE WELL(W), SIF�.P�IC� T�A1N'�K ST)AND RAI LD(QF ,AND ALL DISTANCES TO <br /> UILDINGS, ROADS, LAKE, LOT LINES. �1IIAI � sn POPS > <br /> ,&!INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. IQ— <br /> �f. F SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, ETC.,THE PLANS <br /> MUST BE SIGNED AND DATED BY THE OWNER. jjo <br /> o I <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN y» o <br /> NEEDED. 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> 0 <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. J ( I <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. v W <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 /> m m4CD, � aF M <br /> 6. 3n0x � ;a <br /> o mcN !" o � 3 <br /> 7. Z NMo <br /> o T M <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of myG)c c_ <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of m nd. <br /> CL 0 : .� <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 Co unM, ,-,relythis informationIam mproviding in this applicatio agree ermit county officials charged rrr nc s or other <br /> authorized person to ha cess h above described premises at any r spection. - ° o <br /> l i CD <br /> m m E <br /> SIGN HERE \ Ut 2 '711Zn . <br /> s re o caner or building ontractor) - (dat <br /> ZONING ADMINISTRATOR �) )'x r BURNEIT <br /> ZONING L"t 0 N <br /> N O N N O O <br /> �M O v N 0 0 <br /> TOWNSHIP PERMITS MAY BE REQUIRED <br />