Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator -0 G) (� z <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> r <br /> N <br /> C <br /> N <br /> n <br /> OWNER ` : TELEPHONE �i SL _- l,�S,� •..S7l.S � � <br /> m <br /> MAILINGADDRESS �P CC�>7 ,( f f/ O <br /> o <br /> PROPERTYADDRESS <br /> LEGAL DESCRIPTION(see tax receipt) cn <br /> i N <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION to <br /> TYPE OF PERMIT(S): Q <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISION ❑ a <br /> STRUCTURE/ADDITION USE: �o? X /.2 .5:%vt Rot)M ° <br /> (Home/yabin; Commercial Business, Bedroom; Deck; etc.) <br /> m <br /> 2 <br /> BUILDING CONTRACTOR: <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. -nFIT <br /> G <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> n <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m ,ZZ <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE II ,, <br /> NORTH(N). C W o <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 d <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 <br /> MUST BE SIGNED AND DATED BY THE OWNER. F r <br /> 0. <br /> 7 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN .�'» 0 <br /> NEEDED. c (� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. Z v �f <br /> CONDITIONS OF PERMIT: o <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. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN THE REQUIRED WATER <br /> SETBACK AREA.5. No_ nArA1 �1LLL <br /> 0aov <br /> f m <br /> 6. CD 3 n m x a' CD .'0 <br /> CD X-0 <br /> 'O <br /> 00 tp C y y 0 > �_ <br /> Z <br /> 7. C y CD 0 O <br /> O N TIS <br /> — � m <br /> I declare that this application (including an accompanyingschedule has been examined b me and to the best of m A <br /> PP ( 9 Y ) Y Y LjC - : C <br /> knowledge and belief it is true, correct and complete. I acknowledge that I am responsible for the detail and accuracy of v 0 <br /> all information contained in this application (including any accompanying schedule)and I further declare that 1 recognize m E m <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- CD <br /> cn : C <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett relying on this information I am v o <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> authorized person to have access tot m above described premises at any reasonable time for the purpose of inspection. „ a <br /> m D <br /> m <br /> SIGN HERE 0'L C9 a <br /> (signat of owner o building contractor) (date) 0 <br /> ZONING ADMINISTRATOR <br /> ur: in in <br /> 69 En 69 69 N <br /> G ONVIW W NO <br /> TOWNSHIP PERMITS MAY BE REQUIRED O o N o n cn u o <br /> THIS PERMIT SHALL EXPIRE ONE YEAR FROM DATE OF ISSUANCE <br />