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 . <br /> OWNER vV Q L�ktG (bc�.kC) L4 Y%d2M TELEPHONE �1 L 84oC-�' GI�oZZ- e <br /> w_ <br /> O <br /> MAILING ADDRESS '�}D� £ • l0�o`n Sfi 1� 't M <br /> r � <br /> 0 <br /> PROPERTY ADDRES TIS Ve�'ft b2�VrG Il / lr {t N S rn �C /1 e <br /> LEGAL DESCRIPTION(see tax receipt) �D� % Val g (C}l 0 <br /> � -r » <br /> Kr <br /> DWELLING/BUILDING Irl GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ W 0 <br /> TYPE OF PERMIT(S): c <br /> FILLING/GRADIIN/NG•� J❑ CAMPING UNIT ❑ SUBDIVISION ❑ <br /> STRUCTURE/ADDITIONUSE: c-d.� rt <br /> ( om/e/Cabin;Commercial Business; Bedroom; Deck; etc.) w <br /> 2. <br /> BUILDING CONTRACTOR: <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR n 9 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> 77 y a <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 a <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m m `v <br /> NORTH(N). y 'Z <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m <br /> CENTERLINE OF ROAD,(C)BUILDING(S)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF � � o <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO CX <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. L - 7 O Q <br /> 3 W <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATIOK )AEINHEN ,� o <br /> NEEDED. l <br /> Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. OCT qnn (n <br /> CONDITIONS OF PERMIT: 2003 I <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT �URNETT \ <br /> ISSUANCE. 70 COUNT N <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. NTNG <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY C` <br /> PERMITTED. W <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS,ETC., ALLOWED WITHIN THE REQUIRED WATER Q / <br /> ,SETBACK AREA. <br /> �jO /' 1__ � /U���� �� IUL� <br /> 5. C <br /> wm0gQfm <br /> 6. m 3cyym. � <br /> N N 7 p <br /> y O <br /> 7. O G 3f <br /> rn: : : m <br /> 1 declare that this application (including any accompanying schedule)has been examined by me and to the best of my f7 cC <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of a» ? (0:: F3 <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize a) m O G <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 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other o <br /> authorized person to have access to m a above described premises at any reasonable time for the purpose of inspection. - o <br /> SIGN HERE4n ! /B�/ /�3 '• ; a <br /> (sig ature of ner or building cont r o (date) <br /> c/7a.� <br /> ZONING ADMINISTRATOR d <br /> O N(�lINNOO <br /> d <br /> TOWNSHIP PERMITS MAY BE REQUIRED &4V If (71 O N N O O <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE -{�� <br />