Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,W154872 Office of Zoning Administrator v G) Z <br /> APPLICATION FOR LAND USE PERMITS 3. 4 P <br /> r <br /> w o <br /> N <br /> FL <br /> OWNER - �.- TELEPHONE <br /> HOME ADDRESS <br /> 7si3b Slg .-� i-t4s`j v 0 <br /> EMERGENCY/FIRE NUMBER v ROAD NAMEQ CQ <br /> LEGAL DESCRIPTION(see tax receipt) S-z-z "� 'L-3 _ZZ —\�,0 �� \ co <br /> m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE 25 ADDITION ❑ PRIVY ❑ m <br /> TYPE OF PERMIT(S): or <br /> a <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> N <br /> STRUCTURE/ADDITION USE: G�T�n-���(4�� C 0 <br /> (Home/ abin; ommercial Business; Bedroom;Deck;etc.) ca <br /> BUILDING CONTRACTOR: <br /> v <br /> 1 <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> A <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O o <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C <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)OF111-1 Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. P <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 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. o 4— <br /> NOTE: <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN Cr <br /> W S <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 t <br /> O+ <br /> ISSUANCE. e�- <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY SL <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER (� <br /> SETBACK AREA. <br /> 5. <br /> o0i0 .0 <br /> ? Qka m <br /> i q <br /> to <br /> 6. aE mCis 3 <br /> 7. o w, IS <br /> lam: m <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of c <br /> ate : <br /> all information contained in this application(Including any accompanying schedule)and I further declare that I recognize rn ;a <br /> that this information I am providing will be relied upon by the County-Of 1 ur" tC Wisconsin in determining whether to is- : O <br /> sue a permit. I further accept all liability which may be a resVl, to <br /> Burnett relying on this information I am �? ? <br /> providing in this application. I agree to permit coun bi h Ith nistering county ordinances or other m <br /> authorized person to have access to the above de ri at any reaso b q time for the purpose of inspection. T <br /> `N HERE <br /> of owner Idi g c a O``N (date) <br /> STRATOR <br /> ^``� ON <br /> 1 11 ij <br /> TOWNSHIP PER TS MA BE REQUIRED I` 1VVo 0 0 0 0 0 0 <br /> 000000 00 <br />