Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator v 0 Z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> UF O l <br /> C <br /> /�l�pp N (jCy <br /> OWNER Ssu�X.lsa TEIFPhIONE 3y y_ 7 7S-o v <br /> MAILING ADDRESS <br /> IN htL- SV,?9 <br /> J w-��J / ��/� SAL '- (' 2 m <br /> PROPERTY ADDRESS �f�b!f\eC� "" `' a �c (� �-c.A A-Q_ 9 <br /> LEGAL DESCRIPTION(see tax receipt) t I cn <br /> 11� m <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION ❑ (n <br /> TYPE OF PERMIT(S): Cr <br /> Cr <br /> FILLING/GRAD NG 11 CAMPING UNIT El SUBDIVISION ❑ < <br /> STRUCTURE/ADDITIONOSE: /71e— oZ&X 3O L[1I c <br /> (Home/Cabin;Commercial Bulkiness;Bedr ; Deck,etc.) rn <br /> m <br /> BUILDING CONTRACTOR: rt1t��. sp <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8'/,X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. -n I� <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n m 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: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 33 <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 1 <br /> BUILDINGS,ROADS, LAKE, LOT LINES. ;1 Ce <br /> S. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. C N <br /> 6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER,CONTRACTOR, ETC.,THE PLANS LN <br /> MUST BE SIGNED AND DATED BY THE OWNER. Q F <br /> o o Q <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN g Lo.J <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: o <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT �J <br /> ISSUANCE. QG <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. v <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY C <br /> PERMITTED. <br /> 4. NO STRUCTURES,INCLUDING RETAINING WALLS,ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AR5. EA. /• <br /> (/�'f� m mmo�n� m <br /> 6. 3 am � z <br /> a' mcy " off 3 <br /> 7. Z into : <br /> P <br /> Tom : <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of mycj ID <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of @ C in <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- t7 <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 hayA access to the above described premises at any reasonable time for the purpose of inspection. m o <br /> `� m m <br /> SIGN HERE y^J 03 <br /> (signal f owner or uil /nc/ontrac ) (date) (1 1 m <br /> ZONING ADMINISTRATOR tLL�( <br /> (T <br /> N) 0W(A0 N <br /> NNNOO <br /> `1' cn OCT Cn00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED lJ <br />