Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v0 z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> F <br /> f/1 <br /> —+- / r1 <br /> OWNER U IM TELEPHONE CSR _00 <br /> 11Q o e n <br /> HOME ADDRESSC� Or�\J► <br /> j/7!0 2 l l�a y 7Q <br /> r CD <br /> 0 <br /> EMERGENCY/FIRE NUMBER y76n ROAD NAME ktl(,HwAy 70 <br /> f� /1 P <br /> LEGAL DESCRIPTION (see tax receipt) Q N 1'LO T //Li�i� /\)}j c <br /> CD <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ cn 0 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT 1:1 SUBDIVISION ❑ <br /> 0' <br /> STRUCTURE/ADDITION USE: 44kp pat4Ic- — Foup_ �// wtj A0.2Ch' &E�A, <br /> � ) (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br /> BUILDING CONTRACTOR: /- j_P6� �WAl&K, d <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 =v <br /> rN t <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 O ,m p� <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m o v A <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). y o <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 <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER,BUILDER,CONTRACTOR,ETC.,THE PLANS �. <br /> MUST BE SIGNED AND DATED BY THE OWNER. �� F <br /> NZ� _v. <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN o <br /> NEEDED. �) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> XJ <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. -4) l • <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY O` n <br /> PERMITTED. XJ <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER Q <br /> SETBACK AREA. l77 <br /> s. rblk — /CS� -;)3CY03 if 10th _U 0 rD> 0 > m <br /> 6. ' m 3 a m �a D � <br /> � � N7. <br /> Nos3 <br /> o : Tom : <br /> m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my C) - C <br /> knowledge and belief it is true, correct and complete. I ack t �eLfnrthe detail and accuracy of a <br /> all information contained in this application(including any a i g Rurnett�frely­ln <br /> l; r.ileclare that I recognize <br /> CD <br /> that this information I am providing will be relied upon by th ptetmining whether to is- <br /> sue a permit. I further accept all liability which may be a re u of the County o�this information I am <br /> providing in this application. I agree to permit cou ty offic charg�eAdnwith a inistering c city' ordinances or other <br /> authorized person to haye access to thea a de ibed p es at Ap asv a for a purpose of inspection. m <br /> C : <br /> m <br /> m : <br /> SIGN HEZINIS�TRATO\F <br /> UNT-/T ���—Q <br /> (signature of roc building ntractor) O �^' (date) <br /> ZONING !1 E <br /> TOW HIP PERMITS MAY BE REQUIRED 0 3 <br />