Laserfiche WebLink
Burnett County 7410 Co. Rd. K, No. 102, Siren,WI 54872 Office of Zoning Administrator 'D ci z <br /> APPLICATION FOR LAND USE PERMITS 3 o <br /> OWNER &26-C TELEPHONE (.2 �g.0 <br /> ss33 <br /> HOME ADDRESS 13OOG afoo7j42 J AJ1e Ste+ .due/VS(/ LLc / AI v � <br /> 7— ° r m <br /> 0 <br /> EMERGENCY/FIRE NUMBER lg 7 S ROAD NAME <br /> F � 1 <br /> LEGAL DESCRIPTION (see tax receipt) y0✓ Xo S Ufa. ( 7D 1�� �� \ <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ;K ADDITION ❑ PRIVY ❑ y 0 <br /> TYPE OF PERMIT(S): <br /> FILLING/GRADING ElCAMPING UNIT ❑ SUBDIVISION F-1 13 5 <br /> N <br /> STRUCTURE/ADDITION USE: 1/4&pq G 0 h <br /> 7—y (HQ�e/Cabin; Commercial Business; Bedroom; Deck;etc.) ca <br /> BUILDING CONTRACTOR: /V� A /L XA,,jd) RLQS <br /> v <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR T 3• <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. <br /> N <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) Om <br /> In o. <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). N o <br /> 3. SHOW DIMENSIONS IN FEET OF THE FOLLOWING: (A)BUILDING(S)TO ALL LOT LINES,(B)BUILDING(S)TO m v <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. P <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 d <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. o <br /> o <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAYBE DONE WHEN a <br /> NEEDED. 2 <br /> 1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. c O <br /> CONDITIONS OF PERMIT: (j) <br /> I <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 <br /> 5. REQUIREDAVATER <br /> SETBACK AREA. 7b1 <br /> Gn ip <br /> bit <br /> A y Oto <br /> Z COD <br /> 7. o : <br /> I declare that this application (including any accompanying hedule has bee x ir}eti;-by me and to the best of my c ` p p <br /> knowledge and belief it is true,correct and complete. I ackn ledg I am esponsibhb for the detail and accuracy of m S <br /> all information contained in this application(including any a ompany sch d I fu er declare that I recognize m <br /> that this information I am providing will be relied upon by the of Burnettnsin r�etermining whether to is- E p <br /> ID <br /> sue a permit. I further accept all liability which may be a res:1t P t roof Burnett re �dg on this information I am d <br /> providing in this application. 1 agree to permit county officials char i �r�1�� teri county ordinances or other m <br /> authorized person to have access to the above described premises 'ddlM it a for the purpose of inspection. T <br /> - : <br /> S-� <br /> SIGN HERE 4610 : <br /> (sig tooI owner or building ctor) (date) <br /> ZONING ADMINISTRATOR <br /> 404049diW 40� <br /> N NfTNN (n (T <br /> 17o�-1kct� 0 000000 <br /> WOWNSHIP PERMITS MAY BE REQUIRED 16563- Shed_ 0000000 <br />