Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator m 0 o <br /> APPLICATION FOR LAND USE PERMITS 3 <br /> N O» <br /> CD <br /> OWNER �P If/L- G /����!nl5 TELEPHONE C ���n5 7V.Ez ' ( ,j <br /> MAILING ADDRESS 74 72 0?9& 5-f-- ,��� ��� S O O O <br /> r m <br /> 0 <br /> PROPERTY ADDRESS � � I <br /> su <br /> 6s/ 5 y�t���iP i d uJ Qc2es SF..S�o <br /> LEGAL DESCRIPTION(see tax receipt) 61�/Jpp 2—yi�i(o U/fob m <br /> DWELLING/BUILDING ❑ GARAGE/ACCESSORY STRUCTURE ADDITION ❑ J# S v> 0. <br /> TYPE OF PERMIT(S): �o V 7 f-�f3 cov <br /> FILLING/GRADING ❑ CAMPING UNIT ❑ SUBDIVISIONFT <br /> ❑ <br /> STRUCTURE/ADDITION USE: 15 0,4jP� M/x I a f <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C/ <br /> BUILDING CONTRACTOR: <br /> 42 <br /> T _ <br /> A PLOT PLAN MUST BE PROVIDED ON AT LEAST AN 8%X 11 SHEET OF PAPER. ANY INCOMPLETE OR -n I <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. p <br /> .7J m <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (AERIAL OR TOP VIEW) 0 n <br /> -n O Z <br /> 1. ALL REQUIRED DIMENSIONS OR DISTANCES TO BE SHOWN OR DRAWN TO SCALE. m p <br /> 2. SHOW THE LOCATION AND SIZE OF ALL EXISTING BUILDINGS(EB)AND ALL NEW BUILDINGS(NB)AND INDICATE <br /> NORTH(N). Cn <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. ° <br /> 4. SHOW THE LOCATION OF THE WELL(W),SEPTIC TANK(ST)AND DRAINFIELD(DF),AND ALL DISTANCES TO C7 <br /> BUILDINGS, ROADS,LAKE, LOT LINES. W <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. o F <br /> o 0 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED SO AN ONSITE VERIFICATION MAY BE DONE WHEN a 0 <br /> NEEDED. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. o <br /> CONDITIONS OF PERMIT: <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. f <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. r <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 /> X m <br /> rcDi 0n0� <br /> d <br /> 6. 3 n m F n <br /> 0 C N w O 3 <br /> 7. Z in 0 O 1 <br /> O TQ <br /> in <br /> I declare that this application(including any accompanying schedule) has been examined by me and to the best of my — A <br /> UJ c C <br /> knowledge and belief it is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of pQ a 0 'w A <br /> PP (including Yaccompanying ) g ` c <br /> all information contained in this application Includin an schedule and I further declare that I recognize m m o , my <br /> that this information I am providing will be relied upon by the County of Burnett Wisconsin ' dq ming whether to is- (D <br /> sue a permit. I further accept all liability which may be a result of the Co I F r y this information 1 am m <br /> providing in this application. I agree to permit county officials cha it �g ordinances or other [ <br /> m � <br /> authorized person to have access to the above described premises m for a rpose of inspection. m o <br /> SIGN HERE 5 2002 / - <br /> (signa�f owner or ding contractor) (date) j <br /> ZONING ADMINISTRATOR \ �Im /4 aa ) e►IRNETT COUNT "I <br /> d.v. <br /> ZONIN `"`"`" <br /> N (T N N O O <br /> (TON(TOO <br /> TOWNSHIP PERMITS MAY BE REQUIRED - b <br />