Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872Office of Zoning Administrator v C ' Zi <br /> APPLICATION FOR LAND USE PERMITS 3 4 <br /> r k) <br /> w C <br /> OWNER �� I CD <br /> n D <br /> r I TELEPHONE (� <br /> o <br /> HOME ADDRESS L4SO <br /> EMERGENCY/FIRE NUMBER ROAD NAME DC'V I/ 5 L-kd 2c�- <br /> IIr11 <br /> LEGAL DESCRIPTION(see tax receipt) W <br /> W <br /> i� <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION C <br /> Or <br /> Q (� <br /> S. <br /> SANITARY PRIVY FILLING/G/GRRAADIN,G// CAMPING UNIT SU <br /> BDIVIS-IyON L <br /> Ca P/ <br /> STRUCTURE/ADDITION USE: �^'I 1 1 V a I� fD b D. / ? 0-1 <br /> 6 <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) Q -I _ <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER. ANY INCOMPLETE OR d <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. m 3 <br /> O <br /> DIRECTIONS FOR PLOT PL6N DRAWING- (AERIAL OR TOP VIEW) O o <br /> na <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. 0 Z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE m <br /> NORTH(N). C n <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 LAKE, <br /> STREAM OR RIVER. Z <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO BUILD- o <br /> INGS,ROADS, LAKE, LOT LINES. <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED OR FILLED. <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. c L <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BEFORE A PERMIT CAN BE Vw} <br /> ISSUED. a B <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c <br /> CONDITIONS OF PERMIT: /VVV,��"1 <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. lU� <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC.,ALLOWED WITHIN 75 FEET OF THE OHWM OF LAKES, <br /> PONDS RIVER UNLESS SPECIFICALLY PERMITTED. <br /> 5. <br /> 6. //,1 � (/ /�� �p '. m m <br /> o <br /> 7. � M � It �o 70 ; <br /> i :VI i A <br /> I declare that this application (including any accompanying schedule) has been examined by me and to the best of my a A <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize m m ' m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to Is- E G3 f 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 <br /> providing In this application. I agree to g county 01 <br /> g permit county officials charged with administerin coun ordinances or other m <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. <br /> - i <br /> SIGN HERE al ': <br /> (signature of owner or_building contractor) (date) <br /> ZONING ADMINISTRATOR �1,m Y tail i�� I '• <br /> 'A""W" <br /> N NN N FI)M <br /> N 00 Cn Ca 00 <br /> TOWNSHIP PERMITS MAY BE REQUIRED 0 0 0 0 0 0 0 <br />