Laserfiche WebLink
11,1.j"TV,t;) <br /> Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 0z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> y O <br /> � N <br /> OWNER TELEPHONE TL <br /> HOME ADDRESS Rex 'C/� ��%L S p9� 0 <br /> EMERGENCY/FIRE NUMBER 7Lef2 ROAD NAME C� ,Z IZ ( .. <br /> LEGAL DESCRIPTION (see tax receipt) aZ 7-4f O/V/Z/7 Gt/ to <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION PRIVY ❑ �� q 0 <br /> TYPE OF PERMIT(S): <br /> c <br /> FILLING/GRADING � CAMPING UNIT ❑ SUBDIVISION ❑ 5 <br /> STRUCTURE/ADDITION USE: LeeT. <br /> (Home/Cabin; Commercial Busines , Bedroom; Deck;etc.) m <br /> BUILDING CONTRACTOR: <br /> sP; <br /> m <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> DIRECTIONS FOR PLOT PLAN DRAWING (AERIAL OR TOP VIEW) _ �`/ I /o�Tv'C J`� A4 C C (^ <br /> >�5 � O 1 <br /> O 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 6 <br /> NORTH(N). C 0 <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m 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. 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 '0 O <br /> MUST BE SIGNED AND DATED BY THE OWNER. oy to�o I <br /> o�9 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN o <br /> CrNEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c � ( <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 () <br /> PERMITTED. 1� <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA. <br /> 5. y <br /> M - m m Ara.O <br /> CL , c m <br /> 6. �•� mCh �o9' � <br /> o <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my 6 c p <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m ' C <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m a m <br /> that this information 1 am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- p <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 <br /> authorized person to have41ccods-yo,2flabove described premises at any reasonable time for the purpose of inspection. m <br /> nr <br /> SIGN HERE <br /> (si atu a of owner r Iding contractor) (date) <br /> ZONING ADMINISTRATOR <br /> W 44 fA 49 40 <br /> / V7 { / N NP N N(nP <br /> {-jC9 0O00OO <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br /> l<<f8 q Crztis� <br />