Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102,Siren,WI 54872 Office of Zoning Administrator - o �Z <br /> APPLICATION FOR LAND USE PERMITS 3. <br /> w 0 � I� E <br /> 71 <br /> n (� W <br /> OWNER T hCo^1 /�S Cvc Jr /M/d ti 4Af CyTELEPHONE t1,1 3Z1 t Ufa o 1F\ <br /> (� n, �'! O <br /> MAILINGADDRESS /04/0 W(%115,0A�Mg rIkJ25 ,'tom r—,,J P- a./ j 5!03 7 <br /> PROPERTY ADDRESS/ / o <br /> LEGAL DESCRIPTION(see tax receipt) S �� S i/�— /_ / CD <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ❑ ADDITION ❑ i <br /> TYPE OF PERMIT(S): <br /> FILLING/G DING ❑ CAMPIN.GyU_N,IT ❑ SUBDIVISION <br /> ❑ f�Q X O n <br /> STRUCTURE/ADDITION USE: QSt?J-»Q/7/ <br /> (�-) 99 �1Cattin n¢Ipmerci ine room; <br /> BUILDING CONTRACTOR: I r l9F OK�sAu <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR m 3 <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. O <br /> y <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) O a <br /> m <br /> T O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m m z <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE C <br /> NORTH(N). ° <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)BUILDINGS)MEASUREMENT TO THE ORDINARY HIGH WATER MARK(OHWM)OF (kj Z <br /> LAKE,STREAM OR RIVER AND MEASUREMENT TO WETLAND AREAS. 1 ° <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL PtSTA�ICES TO <br /> BUILDINGS,ROADS, LAKE, LOT LINES. T ZT� <br /> 5. INDICATE IF A WALKOUT BASEMENT IS PLANNED AND SHOW AREAS TO BE GRADED Oji FL6. IF SEPARATE PLANS ARE SUBMITTED BY AN ARCHITECT, ENGINEER, BUILDER, CONTRACTOR, EP NNjS�\ ��.MUST BE SIGNED AND DATED BY THE OWNER. IEIJ J o f <br /> r:d� f <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICAT16 4�IIAY BE�NE WH ° <br /> NEEDED. 2� � <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. `0� CO / / o Jt+ <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT ' It <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. <br /> 5. <br /> m y <br /> W 0 M c. m <br /> W <br /> 6. 2. vaNO9 ;a <br /> a mC: 3 <br /> Z w m o : 1 <br /> 7. ° <br /> -n ` m <br /> -�E [ E M <br /> 1 declare that this application (including any accompanying schedule) has been examined by me and to the best of my G) C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of m n L <br /> 0. <br /> U <br /> all information contained in this application(including any accompanying schedule)and I further declare that I recognize mo C <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 o <br /> 0 <br /> providing in this application. I agree to permit county officials charged with administering county ordinances or other <br /> co <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of inspection. -n m o <br /> CDm <br /> o <br /> SIGN HERE 61 n <br /> (signal f owne r building contractor) (dAte) <br /> ZONING ADMINISTRATOR J�Qal vi <br /> ER fR EA(fl� N <br /> N N N N O O <br /> O UO [P (T O O <br /> TOWNSHIP PERMITS MAY BE REQUIRED C.�?-/' �an i"r a a� <br /> /iia led 1.D Coo k <br />