Laserfiche WebLink
Burnett County 7410 Co.Rd. K,No.102,Siren,WI 54872 Office of Zoning Administrator - o° o <br /> APPLICATION FOR LAND USE PERMITS <br /> N � <br /> N <br /> C <br /> OWNER /V��/l4J I I Iq <br /> TELEPHONE �/S 7f0 3a / 3 <br /> ,E-, <br /> 11 c O <br /> MAILING ADDRESS F <br /> m <br /> 0 <br /> 0 <br /> ' amu Sof 8 3� <br /> PROPERTY ADDRESS � <br /> '1 � <br /> LEGAL DESCRIPTION(see tax receipt) ,�V] SE 5 9 T4-b tl/o (N LIQ QCi I-t S <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION <br /> TYPE OFPERMIT(S): a <br /> FILLING/GRADING 11 CAMPING UNIT 11 SUBDIVISION E] <br /> 02,1O N. Q.�c i�f1%�i j1 trrYi N <br /> STRUCTURE/ADDITION USE: � � <br /> j� (Home/Cabin;C�om� cial Business; Bedroom; Deck; etc.) w <br /> BUILDING CONTRACTOR: v� 'U be * �nQa 7 <br /> v <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 vN <br /> DIRECTIONS FOR PLOT PLAN DRAWING• (AERIAL OR TOP VIEW) In n O <br /> T o z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 a � <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C m cf <br /> NORTH(N). ° <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)70 m v <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. ° <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 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT,ENGINEER,BUILDER,CONTRACTOR, ETC.,THE PLANS o• C:) <br /> MUST BE SIGNED AND DATED BY THE OWNER. O F <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE AY BE DONE WHEN ° <br /> NEEDED. ) / ° <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. / ` p a <br /> CONDITIONS OF PERMIT: App <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60",q PERRMITJ -?ft <br /> w! <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG S <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFIc4�/V �Nry 0-o- <br /> 4. <br /> x C <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETB5. & A A. <br /> M m N 00 m n F ra11 <br /> ° 3 nm �°cn `D <br /> m <br /> 6. m N N N 7 0 <br /> It 7. O N -ice3) <br /> m <br /> I declare that this application (including any accompanying schedule)has been examined by me and to the best of my Lj ; "IE C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of orn <br /> rn <br /> all information contained in this application(including any accompanying schedule)and I further declare that 1 recognize m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- Lj <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 ° o <br /> SIGN HERE <br /> (signature of owner or bullding contractor) (date) -� <br /> CL <br /> ZONING ADMINISTRATOR I 1 <br /> TOWNSHIP PERMITS MAY BE REQUIRED RC ' <br /> I -*S PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> �.a��Q <br />