Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator m o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> r <br /> C <br /> OWNERn TELEPHONE n <br /> 74� r 3 JJ- 7965 0 <br /> MAILINGADDRESS �5 C �Al k I city\ Al /imo/ ?T Cc%L- $'/[L�i O <br /> W <br /> PROPERTY ADDRESS 5 ��' r W. �( o <br /> LEGAL DESCRIPTION(see tax receipt) J <br /> DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ W 0 G <br /> TYPE OF PERMIT(S): 4 <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n _ _ r <br /> STRUCTURE/ADDITION USE: �t4�.YJdV1, o <br /> (Home/Cabin; Commercial <br /> )/Business; <br /> 1Bedroom; Deck; etc.) ( J <br /> BUILDING CONTRACTOR: t. — <br /> �f <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. T <br /> O - <br /> 0 <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O n <br /> T <br /> n Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS (EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m s <br /> NORTH(N). a �. 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m G' 3 <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF 1 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 Q 0 <br /> MUST BE SIGNED AND DATED BY THE OWNER. 0 G` <br /> � o <br /> � � t <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN o <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z <br /> CONDITIONS OF PERMIT: o <br /> i <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT O <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. t <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY j <br /> PERMITTED. 09V v <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER 0 <br /> SETBACK AREA. IOko410- 0 <br /> m umM rDODaO M <br /> 6. x. 3 n02 yam� <br /> p <br /> 7. Z c y m O <br /> O N T� . m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m - ° d+: O <br /> PP ( 9 Y ) Y Y (j � � : C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of m 0 u <br /> all information contained in this application (including any accompanying schedule)and I further declare that I recognize CL m � M <br /> CD <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- w <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 o <br /> providing in this application. I agree to permit county officials charged with admi is ring ounIt ordinances or other m <br /> authorized per to ave cess to the above described premises at any reason e o io D <br /> CL : <br /> N D : <br /> m <br /> SIGN HERE d+ _a <br /> (si ature of owner or b'uiilldinng�contractor) (date) o <br /> ZONING ADMINISTRATOR / {h JUN 3 U 20 <br /> in in v3 <br /> 63 Vi 63 4A� N <br /> TOWNSHIP PERMITS MAY BE REQUIRED BURNETT COUNTY <br /> ZOMNG <br /> THIS PERMIT SHALL EXPIRE ONE YEAR F ISSU F 'O DAT /\ <br /> fe n �i-}- i-c.e-jy-��r-� ,- M fo ul y C�ns4fwh <br />