Laserfiche WebLink
Burnett C#unty 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -D z <br /> APPLICATION FOR LAND USE PERMITS . <br /> C JJ <br /> OWNER Q �� TELEPHONE 'S-�j/�J'-/�6$'� <br /> /� � <br /> m <br /> MAILINGADDRESS g7%r) -TTFFFeEy AV� <br /> J//LL&V77---11? v FO <br /> o <br /> 1111-1q� �/r0PROPERTYADDRESS p, 4r <br /> LEGAL r_ <br /> DESCRIPTION(see tax receipt) C U <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ (n <br /> TYPE OF PERMIT(S): C <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION Eln <br /> < (, � <br /> STRUCTURE/ADDITION USE: <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) (n Q <br /> BUILDING CONTRACTOR: <br /> U <br /> CD <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR T O <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. 0 = C <br /> � O C <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 C fD J O <br /> NORTH(N). C (/ o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m ( (n 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. 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 O <br /> MUST BE SIGNED AND DATED BY THE OWNER. 0 <br /> O n <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. o <br /> CONDITIONS OF PERMIT: <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. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY O <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. This structure to be used as private residential <br /> e. garage/storage only. Not to be used for human <br /> ( w0r0 CD :E m <br /> 6. habitation. 0 F 3 n C x a <br /> 0 m C y N = 3 <br /> Z C y N O <br /> 7. O (ND T`� i0 <br /> I declare that this application (including an acct... 2 i O <br /> pP 9 Y r....�...� ...............� ...... ........ ............�.. ..� ...� ..,,v .v a,.c ..co. v. ..7 i i � � <br /> knowledge and belief it is true, correct and complete. 1 acknowledge that I am responsible for the detail and accuracy of d F N : c <br /> F— <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m 0 <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is m (n <br /> sue a permit. I further accept all liability which may be a result of the County of Burnett rel ing on this information I am <br /> providing in this application. I agree to permit county officials charged with a ml o er <br /> authorized person to have access to the above described premises at any reaso 01( 0=ft ° n <br /> -n <br /> CID D ; <br /> I CID n <br /> SIGN HERE S��� - �' '• °_ <br /> ( ' n re of oVmeptr building contractor) n 5MAR ms i <br /> ZONING ADMINISTRATOR <br /> BURNETT COUNTY 0 o N W W N o <br /> TOWNSHIP PERMITS MAY BE REQUIRED ZONING <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br /> Le�ies�-�rn�� .�nfi !a /�I�i,� ND✓a,Ck s IS=dS- <br />