Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator o 0 <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> t►r�. dSl -HS®-99 Sd N <br /> OWNER C TELEPHONE II ) n <br /> DO+.� w6,A1�. 17ahn�r b a-36�-ag69 a <br /> MAILINGADDRESS 9sb' 3 Qakev Lt, Zwyev Grove. #elelrts 55-077 <br /> o <br /> PROPERTYADDRESS x006 St N %pPd-� Trade Lard <br /> SunriS2- <br /> LEGAL DESCRIPTION(see tax receipt) e <br /> Se-ci-,or, a9 Tow,v 37 QaNre 18 V Pu. bot 7 <br /> ki <br /> DWELLING/BUILDING X GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ rn o <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ n <br /> STRUCTURE/ADDITION USE: C Ab,AJ 0 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) rn , <br /> ii ,, ++ m <br /> BUILDING CONTRACTOR: 4 le- �yiters - d' <br /> v <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 6'/:X 11 SHEET OF PAPER. ANY INCOMPLETE OR 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. OT m �i J <br /> A = <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR 70P VIEW) p n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. n � �y\�'z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A) BUILDING(S)TO ALL LOT LINES,(B) BUILDING(S)TO m a <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. Q 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. ` O <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 O ' r\ <br /> MUST BE SIGNED AND DATED BY THE OWNER. o 0" <br /> o � <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 a Q' <br /> CONDITIONS OF PERMIT: P <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ` Y <br /> ISSUANCE. ) <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. rUV��y, OQ <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. CF <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER :� C <br /> SETBACK AREA. <br /> 5. <br /> A co O r D O D 0 -0 <br /> M cmm n m afm <br /> 6. m n o. 0 0 <br /> 7. S1eer �,n�c, �3g8 0 y N �_ ° ` _ `� <br /> t,+l tL. . m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m — I A <br /> PP ( 9 Y ) Y Y <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of [ d C C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is. ' <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 G o <br /> providing In this application. I agree to permit county officials charged with administering c un ,o I fD i <br /> authorized person to have access to the above described premises at any reasons Ie <br /> T <br /> m D <br /> m <br /> SIGN HERE <br /> (signature of owner or building contractor) (dateL��b I I ❑ ' <br /> ZONINGADMINISTRATOR AUG 1 ` U <br /> 13URNETT COUNTY <br /> O N UI W W N O <br /> TOWNSHIP PERMITS MAY BE REQUIRED o u o u v N o <br /> THIS PERMIT SHALL EXPIRE ONE YEAR ROM DATE OF ISSUANf;PN)NG <br />